To find out the incidence, neonatal outcome and associated maternal antepartum & intrapartum risk factors of meconium stained amniotic fluid (MSAF). DESIGN: Prospective Study. SETTINGS: Neonatal Unit of Hospital and PNC Ward. SUBJECTS & METHODS: Prospective Study was conducted including 100 babies born with meconium stained amniotic fluid who are admitted in NICU and with mother in PNC ward in a period of six months (April 2012-October 2012) excluding those who born with congenital abnormalities. Detail history of babies and mother with MSAF noted with emphasis on antepartum and intrapartum risk factors and outcome in terms of morbidity and mortality. RESULTS: Incidence of MSAF in the study was 8. 98%. Out of 100, 24 babies were admitted to NICU with most common indications being birth asphyxia (16%) and Meconium Aspiration Syndrome (MAS) (6%). Majority babies were delivered through thin Meconium Stained Liquor (MSL) (44%) followed by thick (35%) and moderate (21%). Total number of deaths were 9 and all these babies had thick meconium with severe birth asphyxia. Ninety one babies were born at >37 weeks of gestation and 57 had birth weight over 2. 5 Kg. Nineteen percent were non vigorous requiring tracheal suctioning and positive pressure ventilation at birth. Common mode of delivery was emergency Cesarean in 83% patients. Common maternal and fetal risk factors were fetal distress (30%) followed by Oligohydramnios (30%), Pregnancy induced hypertension (PIH) (24%), anemia (14%), severe anemia (5%), Antepartum hemorrhage (4%) and Antepartum eclampsia (4%). CONCLUSIONS: Oligohydramnios, PIH, anemia and fetal distress were common antenatal and intranatal factors associated with MSAF. Major morbidity and indication for NICU admission was Birth asphyxia and non vigorous babies. Mortality rate was 9% which is commonly associated with thick meconium and severe birth asphyxia. KEY WORDS: Meconium stained amniotic fluid, meconium aspiration syndrome, early neonatal outcome INTRODUCTION: Meconium Aspiration Syndrome (MAS) continues to be threat to many newborns throughout the world with a case fatality rate of 5% (as much as 40%), in addition to short and long term pulmonary and neurodevelopmental sequelae (1) India has the unfortunate distinction of claiming more than a quarter of the total newborn deaths in the world (2). One such attribute is meconium stained amniotic fluid (MSAF) which complicates delivery in approximately 8% to 15% of live births (3). In a large series, MSAF was found in 12% of 1,77,000 live births. MAS occurs in 1-3% of all cases of MSAF and in 10-30% of neonates with meconium aspiration (4). Various risk factors are associated with increased mortality and morbidity in MAS like postterm babies, primipara and grand multipara, unbooked mothers, mothers with toxemia of pregnancy or prolonged rupture of the membranes, infants with moderate or severe birth asphyxia and