Therapeutic hypothermia is the standard clinical practice for neonates with moderate to severe hypoxic ischaemic encephalopathy (HIE). Aim To describe the two year neurodevelopmental outcomes of neonates who were routinely cooled using cool gel packs for HIE in Western Australia. Methods Retrospective study. Cases were identified from the neonatal databases. Information was collected from chart review. Results 65 infants received therapeutic hypothermia, of which 13 had mild, 35 moderate and 17 had severe HIE. There were no serious adverse effects attributable to cooling. All 13 infants with mild HIE survived, of whom developmental outcomes were available on nine; none had severe disability. Among 52 infants with moderate to severe HIE, there were nine deaths (17%) and developmental outcomes were available on 39; the incidence of severe disability was 23%. The risk of death or severe disability was 40% in infants with moderate to severe HIE. Physical growth was adequate at two years of age. Conclusions Neonates undergoing therapeutic hypothermia with cool gel packs had both good survival rates and long term neurodevelopmental outcomes and met international benchmarks. © 2013 Published by Elsevier Ltd on behalf of European Paediatric Neurology Society.