Introduction: Fetal and neonatal death’s leading cause world over is perinatal asphyxia. Perinatal asphyxia can be defined as clinical or biochemical evidence of decrease of oxygen and an increase of carbon dioxide in the body because of the deficient respiratory function at birth with resultant hypoxia and academia. Aims and Objectives: To correlate the NRBC levels in neonates. Material and Methods: This cross sectional study was done in C.U. Shah Medical College and Hospital, Surendranagar between March 2021 to 2022 in 100 patients who have undergone emergency delivery irrespective of indication have been taken to know NRBC’s (nucleated red- blood cell/100WBC’s) as an indicator of Birth asphyxia. Results: Maximum number of asphyxiated babies delivered from women in the age group of 21-25 years i.e. 53% followed by 36% who were in 26-30 years age group. A total of 44% asphyxiated babies born from primigravida women and 56% from multigravida women. Various indications of LSCS showed that 11 asphyxiated babies born due to failed induction, 14 due to fetal dress, 2 due to deep transverse arrest. In 6 babies, cephalo pelvic disproportion, 7 had breech presentation and 6 women had previous LSCS. Fetal heart rate variability shows that it was positive in 56% asphyxiated babies. Association between asphyxia and Apgar score at 1 minute shows that 21% babies had Apgar score 1, 36% had 2 and 43% had 3. Similarly, Apgar score at 5 minute shows that 18% babies had <5 Apgar score and 82% had 6-10 Apgar score. The incidence of birth asphyxia is 56% when there is a fetal heart variability compared to absence of it. The incidence of birth asphyxia is 90% when the NRBCs levels are >15/100WBCS. Conclusion: The study proved evidence that higher nucleated RBC/100 WBCs count was seen in umbilical cord venous blood sample in new born with acute birth asphyxia. Higher nucleated RBC/100 WBC in umbilical venous sample was also correlated with poor, early neonatal outcome i.e., neonatal NICU admission. The level of nucleated RBCs/100 WBCs correlates with acute birth asphyxia and can also be used as an index of early neonatal outcome.