Objectives <p>To address the needs of preterm and term neonates undergoing cerebral magnetic resonance imaging (cMRI), using a recently developed MR-compatible incubator (icMRI) equipped with a 16-channel receiver head coil was evaluated for feasibility and image quality compared to conventional cMRI (ccMRI) using a 16-channel adult head coil.</p> Materials and methods <p>One hundred three consecutive neonates (46 females; 40 ± 3 gestational weeks) underwent clinically indicated cMRI, 53 were examined with an incubator, and 50 without. Normally distributed variables of the two groups were compared using the Student’s <i>t</i>-test. The Wilcoxon signed-rank test was applied for unequal variances. Image quality was subjectively rated on a 5-point scale by two pediatric radiologists, with interobserver agreement and signal-to-noise ratios in the parieto-occipital white matter (SNRc) and basal ganglia (SNRb) calculated. Interobserver agreement was assessed using the quadratic weighted Cohen’s kappa test (ϰ). Mean SNR values between groups were compared using the Student’s <i>t</i>-test.</p> Results <p>Neonates who underwent icMRI had a significantly lower weight at imaging (<i>p</i> = 0.04). Total imaging time was significantly shorter (<i>p</i> = 0.03) using an incubator. icMRI led to a significant increase in SNRc and SNRb across all sequences (<i>p</i> ≤ 0.006), while diagnostic image quality improved from 3.5 to 4.3 points, and image motion artifacts decreased from 31% to 14% with substantial to almost perfect interobserver agreement. Furthermore, icMRI was associated with reduced need for general anesthesia (<i>p</i> = 0.03).</p> Conclusion <p>icMRI is correlated with better feasibility, improved image quality, shorter scan times, and reduced need for general anesthesia compared to ccMRI.</p> Key Points <p><Emphasis Type="BoldItalic">Question</Emphasis><i>Neonatal cerebral MRI requires a precisely controlled environment, including optimal temperature, humidity, and real-time vital monitoring to ensure safety and stability during imaging</i>.</p> <p><Emphasis Type="BoldItalic">Findings</Emphasis> <i>A recently developed icMRI with an integrated 16-channel radiofrequency receiving head coil is associated with improved feasibility and image quality in neonatal cMRI</i>.</p> <p><Emphasis Type="BoldItalic">Clinical relevance</Emphasis> <i>Newborns benefit from a recently developed icMRI with an integrated 16-channel head coil that optimizes safety, handling, monitoring, and transport, while also correlating with improved image quality, reduced scan time’s and reduced need for general anesthesia</i>.</p> Graphical Abstract <p></p>