This study was performed to assess the predictive value of EEG in HIE following acute fetal distress. For 38 full-term neonates, EEG was recorded at least before 48 hours of life and between 2 and 7 days. Neurological outcome was evaluated at a minimum age of one year. Normal or slightly abnormal early EEGs (14 cases) were observed with normal outcome (13 cases) or minor sequelae (1 case). Extremely abnormal early EEGs were associated with death (5 cases), severe sequelae (4 cases) or normal outcome (1 case); among the "intermediate" group (14 cases), improvement of background activity before 7 days indicated a good prognosis (4/5), whereas identical or worsened activity was noted in all cases with a poor outcome. Of neonates 90% with very abnormal EEGs and 64.3% with "intermediate" EEG presented a significantly unfavourable outcome compared with neonates having normal recordings (p < 0.0001). The EEG before 48 hours has an excellent sensitivity rate (94.7%) but a less satisfactory specificity rate (68.4%).