Necrotizing enterocolitis is the most common gastroenterological life-threatening condition that occurs in newborns, mostly premature infants. The exact pathophysiology of the disease is unknown, but it is considered that it is multifactorial etiology, where prematurity is considered the most important. Also, underdeveloped immunity, microbial dysbiosis and intestinal hyperreactivity play an important role. All the reasons above lead to severe inflammation and ischemic necrosis of the intestinal wall. On average, clinical signs and symptoms occur in the second week of life and include a wide range of clinical manifestations such as food intolerance, abdominal bloating, vomiting, presence of blood in the stool, and nonspecific systemic signs. Given the non-specificity of symptoms, the radiological presentation of intestinal pneumatosis, pneumoperitoneum and the presence of air in the portal area, we distinguish three stages of the disease according to Bell based on the clinical picture and radiological findings. Determining the stage of the disease is extremely important when choosing a therapy. Conservative therapy is the first method of choice in almost all situations and includes monitoring of vital functions, elimination of potential harmful factors that may affect the outcome of the disease, continuous laboratory and radiological monitoring and depending on the presence of infection, antimicrobial treatment. If conservative methods do not work or intestinal perforation occurs, surgical treatment is recommended. Surgical treatment should be the last line of treatment due to several long-term and serious consequences- the most common of which is short bowel syndrome. It is important to mention the neurodevelopmental consequences that determine the quality of life after recovery.