The encephalopathy of prematurity is a new concept in the recent ten years. It specifically focuses on brain damage in premature infants. Neonatal neurology, neuropathology, and magnetic resonance imaging studies found that the gray matter injury is accompanied with diffuse white matter injury in the encephalopathy of prematurity. The brain damage could affect brain development. The neurologic outcome is more severe than tissue loss. Encephalopathy of prematurity involves many problems, and it is difficult to make an independent early diagnosis. Imaging examination is an important way to diagnose the encephalopathy of prematurity. Long-term follow-up and individualized treatment are important for improving the prognosis.