Objectives: To assess the compliance of a tertiary care hospital, South India with the ten steps of the Baby Friendly Hospital Initiative following the UNICEF/WHO global criteria. Design: Cross-sectional study Setting: Tertiary care hospital, South India Participants: Staff nurses who are posted in the obstetrics and gynaecology department and the mothers admitted antenatal, postnatal, and labour wards. Results: Only 35% of the staff nurses interviewed received formal training in breastfeeding techniques. Written information about breastfeeding was given to all prenatal mothers (100%) yet, only 75% knew the importance of breastfeeding soon after delivery. Only 62.5% of babies were exclusively breastfed and 51.3% of the babies were breastfed within one hour of birth. Compliance with the Ten Steps of baby-friendly initiative was 66.63%, signifying moderate compliance overall. Conclusion: The compliance to Ten steps of BFHI in low resource setting shows an overall moderate compliance. The Ten Steps of BFHI may be implemented more effectively in all medical facilities through the mothers absolute affection Programme (MAA). More focused approaches are needed to improve the breastfeeding practices even in tertiary care settings in India. Keywords: BFHI, Breast feeding practices, Baby friendly hospital