Objective: To analyze the value of bedside cranial ultrasonography in the early diagnosis of neonatal brain tissue injury in intrauterine distress. Methods: 128 neonates with suspected intrauterine distress admitted to the Yichang Central People’s Hospital from January 2023 to December 2024 were selected as study subjects based on the inclusion and exclusion criteria, and all subjects underwent bedside craniocerebral ultrasonography and MRI, and the results of MRI were used as the gold standard to divide the infants into the brain-injury group (n = 31) and the no-brain-injury The children were divided into brain injury group (n = 31) and no brain injury group (n = 97), and the value of bedside cranial ultrasonography for early diagnosis of brain tissue injury in neonates with intrauterine distress was analyzed. Results: (1) Among the 128 cases of intrauterine distress neonates, 31 cases were examined for abnormal signs, including 22 cases (70.97%) examined by bedside craniocerebral ultrasonography and 28 cases (90.32%) examined by MRI. (2) Bedside cranial ultrasound detected hypoxic-ischemic encephalopathy in 6 cases, accounting for 4.69%, ventricular widening in 2 cases, accounting for 1.56%, intracranial hemorrhage in 8 cases, accounting for 6.25%, periventricular softening of white matter in 5 cases, accounting for 3.91%, and cerebral edema in 1 case, accounting for 0.78%, while MRI detected hypoxic-ischemic encephalopathy in 9 cases, accounting for 7.03%. 3 cases of ventricular widening, accounting for 2.34%, 4 cases of intracranial hemorrhage, accounting for 3.13%, 9 cases of periventricular-intraventricular white matter softening, accounting for 7.03%, and 3 cases of cerebral edema, accounting for 2.34% were examined. Among them, the detection rate of periventricular-intraventricular hemorrhage by bedside cranial ultrasound was significantly higher than that of MRI (P < 0.05). Conclusion: The diagnostic value of bedside cranial ultrasound in periventricular-intraventricular hemorrhage is high, but the diagnostic value is not as good as that of MRI in other brain tissue injuries, and clinically appropriate examination protocols can be selected according to the specific types of craniocerebral injuries.