Congenital infections generally include infections that occur in utero or perinatally. As part of TORCH syndrome, these infections include congenital toxoplasmosis, congenital rubella syndrome, congenital cytomegalovirus infection, neonatal herpes simplex virus encephalitis, congenital HIV infection, and hepatitis virus congenital infections. Lymphocytic choriomeningitis virus and Zika virus can also cause intrauterine infections, while central nervous system damage due to human parechovirus type 3 and Group B streptococcus can occur in perinatal infections. Intrauterine infections present different symptoms and imaging findings depending on the timing of fetal infection, with earlier infections being more severe. Common imaging findings include ventricular enlargement and intracerebral calcifications, but the etiology of ventricular enlargement (i.e., whether due to hydrocephalus or brain volume reduction) and the location of intracerebral calcifications vary by disease. Rapid diagnosis and treatment are crucial for perinatal infections. Definitive diagnosis involves detecting the causative pathogen in cerebrospinal fluid or blood, but obtaining these results can take time. Imaging diagnostics provide indirect evidence for early diagnosis, with MRI, especially diffusion-weighted imaging, being particularly useful.