Purpose : This study was aimed to evaluate the clinical features of hypoxic ischemic encephalopathy(HIE) in children with and without seizures.Methods : Fifty five children who had been diagnosed as HIE at our hospital from June 1999 to December 2011 were enrolled in this study. Subjects were divided into two groups according to the presence/absence of seizures and their medical records were retrospectively analyzed.Results : Among the 55 cases, 34 patients (61.8%) had seizures, while 17 patients (32.2%) did not. Male to female ratio is was 1:1 for the ‘seizure’ group, the ‘no seizure’ group was a 2.5:1. The onset age was 9.7 months for the ‘seizure’ group and 10 months for the ‘no seizure’ group. The most common risk factor was birth asphyxia (17.7%) for the ‘seizure’ group, and prematurity (23.8%) for the ‘no seizure’ group. The most common symptom other than seizure was respiratory arrest for both groups. On radiologic imaging studies of the brain, main lesions were most commonly observed in the cerebral cortex in both groups. The neurologic deficits or death were detected in 67.7% of the ‘seizure’ group, and 76.3% of the ‘no seizure’ group.  There were no statistically significant differences in risk factors between the two groups.Conclusion : Although the characteristics between patients with and without seizures associated with HIE revealed no significant differences, HIE mainly results in death or permanent disability in childhood. Therefore, permanent brain damage may be minimized by early suspicion and treatment in these patients.