Background: Neonatal hypoglycemia is more prevalent and can cause severe neurological sequelae. The objective of this study was to assess the patterns of neuroradiologic changes in neonatal hypoglycemia. Methods: A retrospective cohort study was conducted on 66 neonatal hypoglycemia patients, and the magnetic resonance imaging (MRI) and clinical records were reviewed. Results: Magnetic resonance imaging showed evidences of abnormality in 54.54% (36 of 66) of hypoglycemic infants. The most common abnormal findings were located on the parietal and occipital lobes of the brains. The number of days with hypoglycemia was significantly higher for abnormal MRI infants ( P < .001), and prolonged/recurrent hypoglycemia was remarkably distinguished for abnormal MRI infants ( P < .001). Patients with abnormal MRI findings did not have a lower blood glucose than infants without abnormal MRI findings ( P > .05), but the lowest blood glucose was significantly lower for the patients with seizures ( P < .01). Conclusions: The pattern of bilateral occipital cortical injury is the most common abnormality for neonatal hypoglycemia. The number of days with hypoglycemia, not the lower blood glucose, was significantly related to abnormal MRI infants.