Congenital CMV infection is the most common mother to child infection having spectrum of clinical presentation which can lead to severe neurological sequelae. Early assessment of disease severity from clinical and neuroimage profile is essential to initiate proper treatment and to predict the outcome is crucial. This cross sectional observational study was conducted at Dhaka Medical College Hospital a tertiary care centre of Bangladesh from January 2019 to June 2020 in the department of pediatrics. This study was carried on among 123 infants of aged 0-12 months with polymerase chain reaction proven congenital cytomegalovirus infection over a period of 18 months. Mean age of our study group is 7.01±2.02 months, with male predominance (85.00%); majority of our infants came from lower socioeconomic background of rural area. Only 5.70% took more than two antenatal visits, 70.00% had history of perinatal asphyxia where 54.50% developed neonatal seizure. Microcephaly was present among 69.10% children, epilepsy, movement disorder, central visual impairment, different level of hearing impairment (78.90%) and severe psychomotor retardation (83.80% - 87.80%) was the most consistent initial presentation of our study group. Neuroimage abnormality was present among 94.30% of infants where cortical atrophy (86.20%) and intracranial calcification (55.30%) was the most common findings, different type of congenital malformations was also observed among the study group. Multiple logistic regression analysis showed significant value for abnormal neuroimage findings as a predictor of severity of psychomotor retardation. Congenital cytomegalovirus infection is one of the leading cause of hearing impairment and psychomotor retardation, where neuroimage findings could guide to predict the severity of psychomotor retardation.