Background: Women die every year in India (1, 2) which contribute 20-25% of all maternal deaths in the world. One estimate show that with one maternal death, 15% pregnancies develop complication which necessitates tertiary obstetric care (3). Referral is especially important within obstetrics due to the high numbers of professionals who support a woman through pregnancy and birth, the speed with which action often needs to be taken and the global burden of maternal mortality. The term referral is used to indicate the recommendation of a health care provider at one level of the health system, having limited resources (medications, equipment, skilled professional) to manage a clinical condition for the assistance of an improved resourced facility which is of similar or higher level to assist in or take over the management of patient (4). The government has introduced the referral system to improve the service delivery at tertiary level, reduce workload at tertiary health care facilities, allow maximal utilization of health care facilities, strengthen peripheral infrastructure, improve teaching standard and to promote research activities.so we want to study fetal outcome of all reffered obstetric cases. Methods: This prospective observational study is done at Obstetrics and Gynaecology department of New Civil Hospital Surat for 1-year period after official approval from Ethical Committee. Number of Patients All consecutive consenting referred women in Obstetrics department of New Civil Hospital Surat over a period of 8 months (250 cases) are enrolled in this study after permission from ethical committee. All obstetrics women referred to obstetrics and gynaecology department of new civil hospital, Surat were included. All booked cases who are directly come to labour room were excluded. Results: In our study, 8.72% babies were stillborn. 19.27% babies were stillborn. 44.95% babies were female. 17.43% babies required NICU admission. Conclusion: Earlier and timely referral is necessary in management of obstetrics emergency. Timely referral with proper filled referral slip and telephonic information about the critical referral cases can reduced maternal and fetal mortality and morbidity. Strengthening the peripheral health centre and availability of skilled staff is necessary to identify the high risk pregnancy, so that the initial preliminary essential treatment can be given, and maternal complication due to delayed treatment can be reduced. Health education in rural area, proper antenatal care from 1st trimester from primary health centre, availability of services of skilled birth attendants at the time of child birth, preparedness of emergency LSCS, well organized first referral centre with better transportation facility, availability of blood round the clock, anaesthetic facilities and availability of specialist in the field of obstetrics at the referral unit, availability if NICU and paediatrician will definitely reduce maternal morbidity and mortality.