Aims and Objectives: Assess the association of the congenital malformations with maternal age & analyse the congenital malformations, involving various systems of the body system wise. Materials and Methods: Foetuses of pregnant women attending government hospitals in Hyderabad were screened during a period of one year from October 2011 to September 2012 through ultrasonographic evaluation in the second trimester (12wks to 28wks) for congenital anomalies. Results: The central nervous system involving neural tube defects and musculoskeletal system involvement were the commonest among congenital anomalies affecting elderly maternal age group. Conclusion: Congenital anomalies are increasing in frequency with increasing maternal age & to prevent them more focus should be laid on maternal education, premarital counselling, antenatal care, supplementation with folic acid, prenatal ultrasonography & genetic studies in at-risk individuals.