Increased survival of very preterm infants and extremely preterm infants does not imply an increase in neurodevelopmental sequelae. However, preterm infants remain at high risk of severe cerebral palsy with neuromotor dysfunction and mental retardation. Necrotic or hemorrhagic lesions occurring in the periventricular ring of telencephalic white matter are the most threatening events for the developing brain of these infants. Recent progress in neuroepidemiology, developmental neurobiology and imaging methods has made it possible to revisit the pathophysiology of brain lesions on a multifactorial basis. Treatment and early detection of infections is a priority. Neuroprotective agents capable of arresting neuron cell death (antagonists of the excitotoxic cascade, free-radical antagonists, proinflammatory cytokine antagonists, growth factors) are new strategies for the prevention of cerebral palsy.