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 Inha University Hospital from June 1999 to December 2011 were enrolled in this study. Subjects were divided into two groups by the presence 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 have them. Male to female ratio was 1:1 for the 'seizure' group and 2.5:1 for the 'no seizure' group. The onset age was 9.7 months (range: 0-158 months) for the 'seizure' group and 10 months (range : 0-108 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 causative lesion was 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 from HIE revealed no significant differences, HIE still can result in death or permanent disability in children. Therefore, permanent brain damage may be minimized by early suspicion and treatment in these patients.