Meconium Aspiration Syndrome (MAS) continues to be threat to many newborns throughout world with a case fatality rate of 5%(as much as 40%), in addition to short and long term pulmonary and neurodevelopmental sequale. India has the unfortunate distinction of claiming more than a quarter of the total newborn deaths in the world. In resource poor countries where modern electronic gadgets for fetal monitoring are not available, it is difficult to predict the fetal outcome. Therefore, this study is planned to highlight the antenatal, intranatal factors responsible for MSL and markers for early fetal mortality and morbidity. With this knowledge, we provide approach to enhance health outcomes among neonates by early enactment.