Introduction: Congenital anomalies account for 8-15% of perinatal death and 13-16% of neonatal death in India[1]. A study of distribution of congenital anomalies and their early detection allows decisions to be made regarding termination of pregnancy, in-utero treatment, mode of delivery, postpartum management, counselling of the parents regarding prognosis and risk of recurrence. Methodology: A prospective enrolment of all consenting pregnant women delivering anomalous newborns within 1 year of study period was done. All study variables were studied in detail. Antenatal ultrasound of all women was noted for weeks of gestation, any fetal anomaly, any liquor or placental abnormality. At the time of delivery, all babies were analysed for gross congenital anomalies. Results: 33.33% anomalous babies were born to mothers of age group of 30-39 years. 50% women had significant past medical and/or family history. 26.66% of anomalous babies were associated with anaemia in pregnant women. 66.66% cases were detected by ultrasonography, while 26.6% cases were missed on USG. 76.66% anomalies were detected between 28 to 36 weeks of gestational age. Most commonly involved system is central nervous system in 53.33% cases followed by Musculoskeletal system in 40% cases. Conclusion: The study emphasizes on preventive measures for congenital anomaly such as, premarital counselling, periconceptional care in the form of improving maternal nutrition, folic acid supplementation, avoidance of teratogenic agents and the need of anomaly scan in second trimester for early diagnosis of congenital anomalies and their termination to prevent perinatal morbidity and mortality.