Background Neonatal asphyxia is a disorder in neonates due to decreased oxygenation (hypoxia) and decreased perfusion to organs (ischemia). Duration of asphyxia and early management influence the severity of organ dysfunction, including the heart.Objectives To obtain patterns of cardiac abnormality in neonatal asphyxia in Cipto Mangunkusumo Hospital with echocardiography. Design A cross-sectional study was performed on 22 asphyxiated neonates and 22 other non-asphyxiated neonates from March to October 2008. Inclusion criteria were term neonates, Apgar score :S 6 in the first minute for asphyxiated neonates and ?. 7 for normal/non-asphyxiated neonate. Echocardiographic examination was performed before the age of 48 hours. Results There were 7/22 asphyxiated neonates and 1/22 nonaxphyxiated neonate with heart disease (P <0.05). The most common cardiac abnormality found in asphyxiated neonates was patent ductus arteriosus, followed by atrial septal defect, tricuspid regurgitation, and pulmonary hypertension. Conclusion Cardiac abnormality is significantly found more often in asphyxiated than in non-asphyxiated neonates.