Background:Preterm neonates less than 37 weeks of gestational age are more liable to both hemorrhagic and ischemic injuries due to vascular, cellular and anatomical features of developing brain and physiological instability due to limited cerebral circulatory autoregulation, Cranial ultrasoundis a safe imaging modality with no need to radiationexposure or sedation. Aim and objectives:To verify the role of transcranial ultrasound as a screening tool for hypoxic ischemic injury for preterm infant(below 37 weeks of gestation). Subjects and methods:This cross sectional descriptive screening study was carried out at Radiodiagnosis department upon 165 preterm neonates admitted to the neonatal intensive care unit (NICU). It was conducted from April 2020 to Mars 2021 and designed to include all neonates born before 37 GW after obtaining institutional review board approval from our university and informed consent from the parents. Results:Among all studied preterm 30.9% had abnormal cranial US findings, the commonest abnormalities found were hemorrhage (47%), followed by hypoxic ischemic injury (41.1%) then hydrocephalus among (25.4%). Conclusion:We recommend screening for all preterm babies for hypoxic ischemic injuries. If routine screening is not feasible in all newborns born under 37 weeks of gestational age, a targeted screening for infants with at least one risk factor may be useful.