Version June 2024
| Stage | Classification of NEC | Systemic signs | Abdominal signs | Radiographic signs |
| IA | Suspected | Temperature instability, apnea, bradycardia, lethargy | Gastric retention, abdominal distention, emesis, heme-positive stool | Normal or mild intestinal dilation, mild ileus |
| IB | Suspected | Same as above | Grossly bloody stool | Same as above |
| IIA | Definite, mildly ill | Same as above | Same as above, plus absent bowel sounds with or without abdominal tenderness | Intestinal dilation, ileus, pneumatosis intestinalis |
| IIB | Definite, moderately ill | Same as above, plus mild metabolic acidosis and thrombocytopenia | Same as above, plus absent bowel sounds, definite tenderness, with or without abdominal cellulitis or right lower quadrant mass | Same as IIA, plus ascites |
| IIIA | Advanced, severely ill, intact bowel | Same as IIB, plus hypotension, bradycardia, severe apnea, combined respiratory and metabolic acidosis, DIC, and neutropenia | Same as above, plus signs of peritonitis, marked tenderness, and abdominal distention | Same as IIA, plus ascites |
| IIIB | Advanced, severely ill, perforated bowel | Same as IIIA | Same as IIIA | Same as above, plus pneumoperitoneum |
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