Introduction: Obstetric cholestasis typically occurs during the later stages of pregnancy and is characterized by severe itching, increased liver enzymes, and has multiple causes. Fetal monitoring in intrahepatic cholestasis of pregnancy (IHCP) is difficult as the conventional antepartum surveillance methods are not reliable in predicting the fetal outcome in these patients. This is because of the fact that sudden intrauterine death is seen in IHCP patients with elevated liver enzymes. The present study was done to evaluate the perinatal outcome using serum bile acids in obstetric cholestasis patients. Material and methods: The present observational study was conducted at department of obstetrics and gynaecology of SMGS Hospital among 100 pregnant women with symptoms of pruritis during the study period of one year. Maternal and fetal outcomes were noted and results were analysed using SPSS 25.0. Results: The mean age of patients was 29.34 years. The average serum bile acid was 35.71 umol/L. 60 patients had mild cholestasis and 40 had severe/moderate cholestasis. 85 patients delivered vaginally while 5 through instrumental delivery and 10 delivered by caesarean. The majority of births occurred at or after 37 weeks of gestation. In terms of neonatal outcomes, namely birth weight and Apgar scores at 1 and 5 minutes, they were all favorable. None of the infants had an Apgar score below 7 at 5 minutes. One stillbirth was noticed in the severe cholestasis group. There were no instances of neonatal mortality observed. Conclusion: Further research is required to assess the impact of serum bile acid levels on maternal and fetal outcomes in obstetrics cholestasis, as the current study yielded mostly favorable results. Early delivery at 34 to 36 weeks is recommended if serum bile acids are greater than 100 mmol/l.