Abbreviations: TH -therapeutic hypothermiaFinancial disclosure statement: The authors have no financial relationships relevant to this article to disclose. Funding source: JPB received funding support from Theirworld Potential conflicts of interest: NoneWhat is known about this topic: EEG discontinuity is associated with adverse neurologic outcomes in term infants after hypoxic-ischaemic encephalopathy. What this study adds:In term infants receiving therapeutic hypothermia, EEG discontinuity calculated using a novel algorithm at 24 hours is associated with cerebral tissue injury on MRI and with adverse neurodevelopmental outcomes. Therefore, it may provide a useful tool for early risk stratification when adjunctive therapies are most beneficial. Contributors' Statement:Jonathan M Dunne collected data, carried out the raw EEG data analysis, assisted with the statistical analysis, wrote the first draft of the manuscript and approved the final version of the manuscript.David Wertheim developed the EEG software used to measure discontinuity, assisted with writing the manuscript and approved of the final version of the manuscript.Paul Clarke, obtained ethics approval, collected data, assisted with writing the manuscript and approved the final version of the manuscript.Olga Kapellou reviewed the MR images and approved of the final version of the manuscript.Philippa Chisholm carried out neurodevelopmental testing and approved the final version of the manuscript.James P Boardman reviewed the MR images, assisted with writing the first draft of the manuscript, assisted with statistical analysis and approved the final version of the manuscript.Divyen K Shah conceived the study, collected data, assisted with the EEG reviews, statistical analysis, writing the first draft of the manuscript, approved of the final version of the manuscript and is guarantor. Word Count: 2498Abstract Background and Hypothesis: Prolonged EEG discontinuity has been associated with poor neurodevelopmental outcomes after perinatal asphyxia but its predictive value in the era of therapeutic hypothermia (TH) is unknown. Hypothesis: In infants undergoing TH for hypoxicischaemic encephalopathy (HIE) prolonged EEG discontinuity is associated with cerebral tissue injury on MRI and adverse neurodevelopmental outcome.