Three neonates with enlargement of the lateral ventricle were evaluated with sonography. Two out of 3 patients had hydrocephalus and 1 an ischemic stroke. 3D US improved accuracy in diagnosing and following up hydrocephalus, while the diagnosis of arterial ischemic stroke was immediate. 3D US has the potential to become a valuable additional imaging tool for the evaluation of the paediatric neonatal brain, enabling an earlier diagnosis.