Cranial ultrasonography (CUS) is an excellent and non invasive tool for brain imaging during the neonatal period. It is traditionally performed through the anterior fontanel. Although the advantages of CUS are numerous, there are also diagnostic limitations. Alternative imaging techniques including the use of different transducer types and frequencies and of additional acoustic windows can improve image quality and the diagnostic accuracy of CUS. This review will focus on techniques to be applied for optimizing the performance of CUS in the newborn infant.