Background:The presence of meconium-stained amniotic fluid is a sign of fetal compromise and is associated with increased perinatal morbidity. The objective of this study was to determine the perinatal outcome in pregnant women at term with meconium-stained amniotic fluid (MSAF) and compare it with the outcome associated with clear liquor. Methods:This prospective study was conducted to evaluate the perinatal outcome in meconium stained amniotic fluid. The study group consists of 300 patients in labor with meconium stained amniotic fluid.Result:Among these patients, 50.7% had thick meconium stained liquor, 35% of the patients had thin meconium stained liquor and 14.3% of the patients had moderate meconium stained liquor. In the study group, almost half of the patients were delivered by cesarean section (52.7% vs 37% in the control group) P = 0.001. Fetal distress is the commonest indication for cesarean section in the study group (70.2% vs 18.9% in control group) p = 0.001. In the study group, 31.7% of the babies were admitted for NICU care. The commonest reason for NICU admission was mild respiratory distress (34.7%). The perinatal mortality in the study group was 3.3% as compared to no neonatal death in the control group. (3.3% Vs 0); P = 0.17.Conclusion:The incidence of non-reassuring fetal heart rate pattern is significantly higher in women with meconium stained amniotic fluid in labor. The perinatal outcome is good in patients with meconium stained amniotic fluid and reactive NST. So, meconium in the amniotic fluid is associated with obstetric hazard and significantly increased risk of adverse neonatal outcomes, only when it is associated with fetal heart rate abnormalities. The main clinical value of meconium stained amniotic fluid is to alert the obstetrician to look for further signs of fetal compromise.