The clinical picture of cerebral palsy (CP) develops subsequently to hypoxic/ischaemic or inflammatory/toxic injury of the developing central nervous system in the pre-, peri- or postnatal period. The present chapter focuses on pathophysiological aspects and the neuropathological alterations observed in CP. The pathologies described comprise: (a) periventricular leukoencephalopathy, (b) germinal/ventricular haemorrhage, (c) por−/hydranencephaly, (d) pontosubicular neuronal apoptotic necrosis, (e) cortical border zone infarction/ulegyria, (f) territorial infarction, (g) marbled state, (h) multicystic encephalopathy, i) hyperbilirubinaemia and (j) infections. The neuropathological findings particularly underline the importance of localisation, extent and timing of brain injury for the clinical picture, whereas data on brain development may indicate possible time windows for therapeutic intervention.