Introduction: Birth asphyxia is a leading cause of death and neurodevelopmental problems in children. Perinatal insult is the common cause for brain injury and therapeutic hypothermia is said to be beneficial. State of the art equipment for hypothermia is costly and may not be available in institutions where birth asphyxia is common. Aims and Objectives: To compare the effect of low-cost cooling techniques with high-cost cooling techniques in terms of morbidity and mortality and neurodevelopmental outcome at 12 months age. Methods: All the term babies who present within 6-12 hours of birth and have moderate to severe encephalopathy will be recruited. Babies will be randomised for Low cost or high-cost cooling technique. Babies will be started on therapeutic hypothermia and will be monitored as per protocol. This will continue till 72 hours and then slow re-warming will be achieved. Any complications will be treated as per NICU protocol. Baby will be discharged when feeding is achieved and is vitally stable. Baby will be followed up until one year of age. Outcome Measures: Death, duration of stay, neurological status at discharge and neurodevelopmental outcome at one year will be the outcome measures.