ZIKV emerged as a new global health threat. Since the ZIKV outbreak in Americas in 2015 and following WHO declaration of ZIKV as a potential public health emergency of international concern in February 2016, large number of data has been generated regarding ZIKV pathogenesis, transmission routes, diagnosis and vaccine development. A surge in the amount of infants with CNS abnormalities accompanied the spread of ZIKV to the Americas. Although much data has been collected about ZIKV infection during pregnancy, limitations of diagnostics and challenges of accurate serologic diagnosis of acute ZIKV infection, restricts the understanding of this perinatal infection to infants born to mothers with ongoing clinical disease during pregnancy. Consequently, the spectrum of the disease in infants exposed to ZIKV in utero remains to be defined.