Aim of this study is toassess the baseline pattern of obstetric sonography referrals, indications and findings at Tertiary care hospital.Methods: Hospital basedprospective study which was conducted in the Department of Obstetrics & Gynaecology, for a period of 6 months, after taking the approval of the protocol review committee and institutional ethics committee. A total of 100 cases were referred to the higher centre due to various reasons.Results: 65 (65%) of the cases in this study were 20-30 years old. The majority of referrals were primigravida 48 (48%). Out of 100 referred patients, 90 delivered and 5% were conservatively treated. In 5 patients (5%) abortion, medical termination, ectopic pregnancy, or tears were managed according to procedure based on gestational age upon diagnosis. Of the 90 babies delivered at our institute, 63 (70%) were delivered naturally and 27 (30%) via caesarean section. Early membrane rupture (17%) was the leading cause of referral in this study. Pre-eclampsia (16%) and meconium-stained liquor (10%) follow. Previous cesarean sections referred 5% of cases. In this study, 6% of cases were referred due to blood and doctor shortages. Our hospital received 64%, 24%, and 12% of cases during intrapartum, antepartum, and postpartum.Conclusion: We conclude that prompt referral is essential for maternal and fetal success. Health care providers should be taught in essential and emergency obstetric care to prevent morbidity, mortality and eliminate unnecessary referrals which increase the tertiary care hospital burden.