Background: Birth asphyxia remains a significant global health concern, contributing to neonatal morbidity and mortality.The study aimed to evaluate serum lactate dehydrogenase (LDH) levels in term neonates with birth asphyxia and assess their correlation with Apgar scores, resuscitation needs, and associated complications. Material and Methods: This prospective study included 120 term neonates diagnosed with birth asphyxia, defined by an Apgar score <7 at 5 minutes or requiring resuscitation at birth. Serum LDH levels were measured within the first 24 hours of birth using an automated enzyme assay (cobas c 111, Roche Diagnostics). Data were analyzed using SPSS 21.0, with a p-value <0.05 considered statistically significant. Results: Among the neonates, 54.17% were male, and 56.67% were delivered vaginally. Apgar scores at 5 minutes were 4-6 in 85.00% and 0-3 in 15.00%, with 65.83% requiring resuscitation. LDH levels were 801-1000 U/L in 33.33%, 600-800 U/L in 29.17%, and >1000 U/L in 20.83%, correlating significantly with lower Apgar scores (p <0.05). Hypoxic-ischemic encephalopathy (HIE) was the most common complication (39.17%), followed by respiratory distress syndrome (23.33%) and seizures (15.83%). Conclusion: Serum LDH levels were significantly elevated in neonates with birth asphyxia and correlated with Apgar scores, resuscitation needs, and complications such as HIE. Given its cost-effectiveness and accessibility, LDH can be integrated into neonatal care protocols for early diagnosis and risk stratification.