Background:Antenatal care provides numerous benefits that result from clinical and psychosocial interventions. By providing medical services, counseling and investigations, antenatal care can lead to improved health outcome for women and the fetus. The present study was conducted with the aim to assess maternal serum alphafeto protein (MSAFP) level in second trimester. Materials & Methods: The present study was conducted in the postgraduate department of Gynaecology and Obstetrics, Lalla Ded Hospital, Government Medical College Srinagar, over a period of one year. This study was conducted in 250 patients with their consent. Blood was taken for estimation of maternal serum alpha-fetoprotein. Results: Maximum patient were in the age group of 28-31 years i.e. 104 (41.6%) followed by 80 patients (32%) in the age group of 24-27 years followed by 35 (14%) patients in the age group of 32-35 years followed by 31 (12.4%) patients in the age group of 20-23 years. Primi was seen in 170, Para 1in 53 and >1 para in 27 patients. The mean of the maternal serum alphafeto protein (overall) was 65.32+33.95. The mean of the maternal serum alphafeto protein in pregnancies with normal outcome was 53.47+25.65. The mean of the maternal serum alphafeto protein in pregnancies with adverse outcome was 92.96+34.99. Conclusion: Raised serum alpha-fetoprotein levels in second trimester in absence of neural tube defects can be a useful predictor for adverse pregnancy outcome.