Objectives <p>To ascertain the impact of skin to skin contact (SSC) on cardiac and cerebral indices in infants with severe perinatal asphyxia.</p> Study design <p>Prospective comparison of cardiac function and cerebral perfusion-oxygenation in incubator care with SSC using echocardiography and near infrared spectroscopy (NIRS).</p> Results <p>13 infants formed the study cohort; gestation and birthweight were 38.6 ± 1 weeks and 3173 ± 724 g, respectively. All infants were cooled for 72 h and the study intervention was done on day 6 of life (range 4–7). Right ventricular output was higher (231 ± 60 vs 296 ± 72 ml/kg/min, <i>P</i> = 0.03) and pulmonary vascular resistance index was lower (3.5 ± 0.6 vs 3 ± 0.16, <i>P</i> = 0.01) after SSC. Middle cerebral artery resistive index trended lower (0.72 ± 0.05 vs 0.65 ± 0.1, <i>P</i> = 0.07). Six infants had NIRS measurement; cerebral tissue oxygenation index during SSC was significantly higher than pre-SSC (68.6 ± 6.6 vs 63.7 ± 4.7%, <i>P</i> = 0.03).</p> Conclusion <p>In severely asphyxiated infants, 60 min of SSC confers significant haemodynamic benefits.</p>