Intraventricular hemorrhage in the premature neonate has been and continues to be a cause of morbidity and mortality in NICUs around the globe. Much information is available concerning the etiology and preventative and treatment strategies to reduce the incidence of IVH in this patient population. As neonatal caregivers are struggling to care for and protect infants who are surviving despite extreme prematurity, this survival is complicated by the infant's cerebral vasculature, which is very susceptible to hemorrhage; by respiratory problems that require the use of lifesaving, but potentially harmful, ventilation interventions; and by the infant's compromised ability to self-regulate vascular responses to stress. The preventative treatments being explored and proposed may come with debilitating and potentially lethal sequelae. Research continues, however. New recommendations are being proffered, and perhaps, in the near future, the incidence of IVH and its associated morbidity and mortality will decline dramatically.