Background: Mullerian developmental defects are congenital anomalies of the female reproductive tract that may adversely affect a woman’s obstetric and gynaecological health. Uterine anomalies arise if there is agenesis of one or both mullerian ducts or absence of fusion or reabsorption of the septum between these ducts. The defect may be partial or complete and may affect one or multiple parts of the tract. AIM: This study was done to assess the spectrum of clinical presentation of mullerian duct anomalies and it’s reproductive outcome in a tertiary care centre. The role of imaging MRI , diagnostic hysterolaparoscopy, treatment options, surgical interventions, effect of mullerian malformations on reproductive health and fertility was reviewed. Material and methods: The present study is a retrospective study including all cases diagnosed to have mullerian duct anomalies. Cases were worked-up and investigated to reach a final diagnosis and case-based management was done. All cases were assessed in terms of clinical presentation, classification, impact on reproductive outcome and managed accordingly. Results: In our study period, we managed total of 49 cases with different mullerian anomalies. The main presenting symptoms were cyclical pain abdomen, primary amenorrhoea, infertility and recurrent pregnancy loss. Most of the patients belonged to the young age. With optimum surgical management, we reported good patient outcome for all the cases. Conclusion: Cases of mullerian anomalies should be dealt with empathy, proper work-up and case-based management lead to a good patient outcome and improved quality of life.