Background: Maternal mortality remains a major challenge to health systems worldwide. Women in developing countries often face serious health risks during pregnancy and delivery due to poor access to early and appropriate referrals. Especially in developing country like India, major population lives in rural areas lacking access to essential obstetric facilities. In such areas timely referral of obstetric cases can reduce maternal morbidity and avoid maternal deaths. The referral system is an essential component of any health systems which is particularly important in pregnancy and childbirth for providing access to essential obstetric care. Hence the study was conducted to review the reasons for referral of obstetric cases referred to department of Obstetrics and Gynaecology at tertiary care centre