The main objective of intrapartum fetal monitoring is reduction or prevention of congenital neurological deficit and other intrapartum adverse events by screening for intrapartum hypoxia/acidosis. With an aim of evaluating role of admission test in predicting the adverse fetal outcome in high risk pregnancies in Government Chengalpattu Medical College, a cross-sectional study was designed including 50 high risk patients and 50 low risk patients. All the patients were subjected to a standard clinical evaluation using a proforma and subsequently subjected to admission test for 20 mins and their readings were grouped into 1. Reactive, 2. Suspicious, 3. Ominous. Intervention is planned based on the tracings of the admission test. The data from the admission test were compiled and subjected to statistical analysis. At the end of statistical analysis, it is found that electronic fetal monitoring has high sensitivity and low specificity. Antepartum risk factors are a poor predictors of fetal outcome. A normal tracing carries a predictive value of over 95% for APGAR score of 7 or greater and an abnormal tracing carries a predictive value of about 50% for APGAR score less than 7. In high risk cases admission test is more sensitive and in low risk cases the admission test is more specific. The negative predictive value for both groups were 85.2% and 97.7%.