Before or during birth, a small number of infants experience reduced oxygen or blood supply. After birth, some of these infants will show abnormal neurological behaviour, diagnosed as hypoxic-ischemic encephalopathy (HIE). The consequences of HIE for the infant, their family and the wider society are considerable. Therapeutic hypothermia (TH) is a therapy which involves cooling an infant to a targeted temperature below an infants’ normal core body temperature and is now the standard treatment for term infants (babies born after 36 completed weeks of gestation) with moderate to severe HIE. Research has demonstrated TH reduces the rate of death, severe disability and lifelong cerebral palsy for infants born with HIE. A standardised dataset was developed to collect detailed clinical data on the maternal, infant and clinical characteristics associated with TH. In Ireland, TH is administered in the four tertiary maternity hospitals, whereby infants born in other hospitals requiring this treatment are transferred to one of these four tertiary hospitals. Anonymised data were collected on site in the 19 maternity units/hospitals and neonatal intensive care units or special care baby units (NICU/SCBU) in the Republic of Ireland on all infants requiring TH between 1 January 2016 and 31 December 2017. Over the two year period, 140 infants required TH which suggests that one in 900 infants born in Ireland during 2016/2017 required TH. Nulliparous women accounted for 60% of the TH cohort (n=84). Of the women whose infants underwent TH, 18.6% (n=26) experienced maternal pyrexia during labour and 10% of women had a prolonged rupture of membranes (n=14). Less than 2% of mothers had an elective caesarean section. At one minute after birth 79.7%; of infants had an Apgar score between zero and three (n=110). Almost all infants required resuscitation at birth (95%; n=133 of 140), with 59.3% of infants needing intubation (n=83). Over the two year period, 60% (n=84) were born in a tertiary hospital with 40% (n=56) of infants requiring transfer from a regional or local hospital. The survival rate for the TH cohort was 88%, as 17 of the 140 infants died. The findings of this audit illustrate the logistical challenges faced with the delivery of a high acuity, uncommon treatment that has to be delivered on short notice. These findings also highlighted that there was an overrepresentation of complications preceding and during the delivery of the infants requiring TH.