Objective: Therapautic hypothermia changes the predictive values of prognostic evaluation in cases of hypoxic-ischemic encephalopathy. The aim of this paper is to evaluate the validity of the different prognostic tests under hypothermic conditions and suggest new cut-off-values for interpretation. Background: Hypothermia is the first treatment shown to improve outcome in infants with HIE. Despite treatment, nearly 50% of the children dies or survives with severe neurologic disability. Most deaths followed perinatal asphyxia results from a decision to draw back life sustaining treatment. A delayed decision of treatment withdrawal leads to an opportunity to make a more accurate prognosis, but with the risk that the child survives with severe neurological disability. Method: Literature search in Pubmed was performed in the period of October 2012 to may 2013. Articles were included if they evaluated outcome in term infants with perinatal asphyxia and HIE, evaluated prognostic tests (and not mainly selection for treatment), contained unambiguous information about outcome, and was tested under hypothermic conditions (with the exception of MRI/S). The quality of the studies were evaluated according to a checklist. Result and Conclusion: The decision of treatment withdrawal is made on the foundation of an extensive evaluation in collaboration with several sub-specialists. Hypothermia treatment has changed the premises for interpretation of clinical evaluation and neurofunctional tests. The clinical evaluation represents the foundation of all clinical medical work, and the value is incontrovertible. But, the classic, modified clinical evaluations will, used unmodified, give an impression of a poorer prognosis than what is the actual case with the baby treated under hypothermic conditions. aEEG distinguishes itself as an easy accessible, objective measure of brain-function. An abnormal pattern that persists beyond 48 hours of age will have a high positive predictive value for prediction of poor outcome, appearance of SWC during the period of cooling predicts a good outcome, while never developing SWC predicts a adverse outcome. MRI is a predictor that is not affected by HT. But there is still uncertainty concerning when the appearance of brain injury detected by MRI, represents irreversible changes. Most studies use a broad time-interval of testing.