Abstract Aim: The aim of the study was to understand the factors causing meconium aspiration syndrome (MAS) in relation to gestational age and birth weight and their immediate outcome. Methods: This study was carried out in Neonatal Intensive Care Unit of Surabhi institute of medical sciences Siddipet, Telangana. The study included the clinical profile of consecutive 50 cases of meconium aspiration syndrome admitted to the above center during the period of July 2021 to January 2023. Results: The mean birth weight of babies with MAS was 2.68 kg (1.7- 4 kgs). In these study, maximum number of cases of MAS were seen in babies with birth weight between 2- 2.4kgs (n=19, 38%), followed by babies with birth weight between 2.5-2.9 kg (n=16, 32%). Babies with birth weight between 3-3.4 formed 22% (n=11) of cases. MAS were also seen in preterm babies. 4 (8%) cases were of 34-36 weeks of gestation and 4 cases (8%) belonged to 36-38 weeks of gestation. None of the cases were below 34 weeks of gestation. In this study of babies with MAS, the most common complication was birth asphyxia in (38%, n=19) of cases, followed by ARF in (n=10, 20%) cases. Septicemia was seen in 18% (n=9) cases, pneumothorax in 8% (n=4), pulmonary hemorrhage in 4% (n=2) and pneumonia in 4%. (n=2) of cases. Conclusion: MAS is an entity which is commonly seen in term and post term babies with birth weight >2.5 kg. There is a significant correlation between the birth weight and outcome in MAS. When thick meconium stained liquor is noted prior to birth, anticipation is necessary and non vigorous babies need aggressive management and possibly early ventilation. Asphyxiated babies should be followed up astutely. Continuous monitoring and early intervention, followed by due resuscitation as per guidelines can reduce the morbidity, complications and the mortality in MAS.