Aim and Objectives: The aim of our series is to report risk factors, trend of clinical presentation and management of rhino- orbito- cerebral mucormycosis (ROCM) cases among COVID- 19 patients. Methods: At our tertiary care hospital, we gathered demographic, clinical and treatment data of first 20 cases of ROCM in COVID 19 who presented to us between April- May 2021. Treatment according to recent guidelines based on Sion Hospital scoring system (SHSS), were chosen between: 1. conservatively with systemic anti fungals ± functional endoscopic sinus surgery (FESS) or 2. ± transcutaneous retrobulbar Amphotericin B (TRAMB) 3. ± exenteration Results: Seventeen patients were males (mean age of 53.1± 10.6 years). Of these, 75% acquired mucormycosis post recovery from COVID. Mean duration of COVID illness was 17.6± 3.3 days. All patients received steroids and voriconazole during COVID, 85% had 6- 8 days ICU stay within that month, 75% were diabetics and had poor orodental hygiene, 75% received combination of meropenem, doxycycline, piperacillin- tazobactum and meropenem- tazobactum followed by and the rest received doxycycline and ceftriaxone alongside treatment for COVID. Ten percent received tocilizumab. Ninety percent needed oxygen support including 2 Bipap, 12 non rebreathable mask (NRBM) and 5 oxygen mask. As per clinic- radiological assessment, 50% had 3D stage ROCM, rest ranged between 2B- 4D. As per SHSS (mean score of 26± 11), 60% patients were managed conservatively, 35% were given TRAMB and one unilateral exenteration was done. Among these patients, 85% survived, rest succumbed to COVID sequelae. Conclusion: Long ICU stay, superantibiotic and immunomodulator overuse, prolonged oxygen support must raise alertness to identify ROCM, especially in immunocompromised patients. Metabolic control, intravenous amphotericin B administration, endoscopic debridement are mainstay treatment. As an adjunct, exenteration is indicated clinicoradiologically, not merely in loss of vision, proptosis and ophthalmoplegia.