Sonography of the neonatal brain is an important diagnostic tool, but the posterior fossa is often poorly visualized due to its location. This study evaluated adding images through the posterolateral fontanelle to the standard anterior fontanelle approach. Of 1292 neonatal sonograms reviewed, 24 showed posterior fossa abnormalities. Posterolateral fontanelle images better displayed abnormalities in 23 cases and increased diagnostic confidence in 18 cases. In 11 cases, it was the only view revealing abnormalities. Follow-up confirmed most findings, though 4 cases of suspected vermian defects were false positives. Adding posterolateral fontanelle imaging significantly improved posterior fossa evaluation.