An understanding of congenital infections is vital for those caring for newborns as these infections cause significant life-long morbidity. The term “TORCH,” once a preferred mnemonic for the common causes of congenital infections, was meant as a memory aid to recall the list of usual etiologic suspects. T was for congenital toxoplasmosis; O was for others and included varicella, syphilis, and parvovirus B19; R was for rubella; C was for cytomegalovirus (CMV); and H was for herpes simplex virus (HSV). The reason that the use of “TORCH” has fallen from favor to describe all congenital infections is twofold. First, not all of the “TORCH” infections were truly congenital. The vast majority of neonatal HSV infections (the H in TORCH) are perinatal, not congenital meaning that the exposure to HSV happens perinatally during the birth process, not in utero. Second, there are now many other infections that have been recognized as potential congenital and perinatal pathogens that would need to be added to the O (for other). Some examples include Zika virus, West Nile virus, lymphocytic choriomeningitis virus, adenovirus, enteroviruses, hepatitis B virus, hepatitis C virus, human immunodeficiency virus, and human T-lymphotropic viruses I and II. This chapter outlines the incidence, modes of transmission, clinical manifestations, diagnostic methods, treatment options, and long-term sequelae of the most common and most classic of these congenital and perinatal infections.