Neonatal seizures are seizures occurring within the first 28 days in a full-term infant and extending to the 44 completed weeks gestational age in the preterm infant. The neonatal period is the most vulnerable of all periods of life for development of epileptic seizures. Most neonatal seizures are acute reactive (structural/metabolic) seizures, the most common cause being hypoxic-ischemic encephalopathy, stroke, or infection. Neonatal seizures appear most often early after birth, usually during the first 1 to 2 days of life. Neonatal seizures may be associated with neurodevelopmental delay or death, with possible long-term motor and cognitive problems. Elissa Yozawitz MD, Emma Laureta MD, and Solomon L Moshé MD of the Department of Neurology and Pediatrics at Albert Einstein College of Medicine in Bronx, New York, present this information as well as the pathophysiology, localization, diagnostic workup, differential diagnosis, and updates in the management of neonatal seizures.