Objective To study the imaging diagnostic value of magnetic resonance imaging (MRI) inneonatal hypoxic-ischemic encephalopathy. Methods 80 children with neonatal hypoxic-ischemic encephalopathy treated in our hospital from January 2015 to December 2016 were selected as subjects. All children were examined with MRI and the number of lesions was recorded. MRI findings of brain injury were typed according to the result of film reading. With the clinical grade of neonatal hypoxic-ischemic encephalopathy as a standard, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of MRI were calculated. Results In this study, MRI detected cerebral edema in 19 cases, intracranial hemorrhage in 24 cases, cerebral white matter damage in 75 cases and abnormal signal in basal ganglia in 9 cases. In 80 children with neonatal hypoxicischemic encephalopathy, there were a total of 129 lesions detected, including 103 lesions detected by T1WI, 72 lesions by T2WI and 117 lesions by FLAIR.80 children with neonatal hypoxic-ischemic encephalopathy were graded according to clinical symptoms, including 37 mild cases, 25 moderate cases and 18 severe cases. With the clinical grade as the standard, MRI grading was correct in 65 cases. The mild diagnostic coincidence rate, moderate diagnostic coincidence rate and severe diagnostic coincidence rate were 87.5% (70/80), 81.3% (65/80) and 93.8% (75/80), respectively. The total diagnostic coincidence rate was 81.3% (65/80), and the Kappa value was 0.707. Conclusion MRI can objectively reflect the neonatal hypoxic-ischemic encephalopathy and pathological features of the lesions, which plays an important role in clinical treatment guidance and the evaluation of prognosis.