Necrotizing enterocolitis is a gangrenous intestinal inflammation characteristic for neonatal age. It is one of the most mysterious diseases with unknown pathogenesis however it is acknowledged as multifactorial. Necrotizing enterocolitis has a broad spectrum of clinical manifestations which may vary from the typical image of a prostrated newborn with a large and taut belly as well as with bloody stools and vomiting content colored bile, or to a picture of a child with a casual finding blood in the stool and that can't stand the food or can't reatin food in the stomach. The disease is diagnosed based on clinical features complemented with radiological and laboratory findings. Treatment can be conservative such as compensation of fluid, mechanical ventilation, decompression of the gastrointestinal tract with nasogastric tube, interruption of enteral feeding with the transition to a fully parenteral nutrition and the application of antibiotics. In addition to conservative treatment, if there is an indication we proceed to the surgical treatment. Depending on the extent of disease and patient characteristics, a number of different surgical options may be undertaken including resection of clearly demarcated gangrenous bowel with enter ostomy, resection with anastomosis and in situations with marginally viable bowel or multifocal disease decompression with proximal enter ostomy or combination of different decompression and drainage surgical techniques. Especially in group of very small birth weight babies with necrotizing enterocolitis the use of peritoneal drainage could be used as treatment option. Great importance is paid to finding effective methods of prevention necrotizing enterocolitis that is still not found despite significant scientific efforts.