Thrombocytopenia is second to anemia as the most common haematological abnormality during pregnancy. It was a prospective observational study. Diagnosed cases of thrombocytopenia in pregnancy with gestational age more than twenty eight weeks without history of Diabetes Mellitus, Collagen disorders, Tuberculosis, Epilepsy, Liver and renal disorders and fetal anomalies were followed up till delivery according to institutional protocol. Maternal and perinatal outcome were studied. Most common complication in our study was Abruption 46.3% followed by PPH 20.6%, acute renal failure 16.7%, pulmonary edema 9.3%, pulmonary embolism 3.7%, Puerperal sepsis 3.7%.There were 21 maternal deaths (7.7%). Most common cause of death were pulmonary edema and hypovolemic shock (23.8%).Outcome of pregnancy with moderate to severe thrombocytopenia depends mainly on the etiology of thrombocytopenia. Adverse outcomes are especially seen with pregnancy complicated by preeclampsia and HELLP Syndrome.