Abstract : Hypoxic-ischemic encephalopathy (HIE) remains a primary cause of permanent neurological deficits in neonates. Therapeutic hypothermia (TH) is currently the only intervention with proven neuroprotective efficacy, and the aim of this study is to analyze its impact on the clinical prognosis of patients. Based on a literature review, it has been demonstrated that the implementation of a cooling protocol (33.5°C for 72 hours) within the first 6 hours of life reduces the risk of death and disability by approximately 25% (RR 0.75). TH significantly reduces the incidence of cerebral palsy and improves psychomotor outcomes at school age. Despite the occurrence of adverse effects such as bradycardia or thrombocytopenia, the method is characterized by an acceptable safety profile. Magnetic resonance imaging (MRI) (days 4-10) and biomarker analysis (S100B, NSE) are of critical importance in prognosticating outcomes. Hypothermia currently constitutes the gold standard of care, and the further development of neuroprotection is associated with the implementation of adjuvant therapies.