Hypoxic-ischemic encephalopathy (HIE) is a common cause of neonatal mortality and neurological sequelae. Insulin-like growth factor-1 (IGF-1) is a neurotrophic factor and anti-apoptotic factor that plays an important role in the development and maturation of the central nervous system. In this paper, we intended to provide a new idea and recent progress of HIE by illustrating the mechanism of action of IGF-1 in neuroprotection, nerve repair and neovascularization after brain hypoxia-ischemia injury.