Introduction: The umbilical cord supplies the fetus with oxygenated, nutrient-rich blood from the placenta. It is a delicate structure and is protected by Wharton’s jelly, amniotic fluid, helical patterns, and coiling of vessels as it is vulnerable to kinking, buckling, compressions, stretching, traction, entanglement and torsion which may affect the perinatal outcome. Abnormal umbilical cord coiling index has been seen in preeclampsia and diabetes. Its determination may provide information to potential perinatal adverse events. Our present prospective analytical study aims at calculating the UCI postnatally and identifying if there is any association between coiling index and perinatal morbidity and mortality. Study Design: 100 singleton live babies with >28 weeks gestational age were examined by single observer. The umbilical coiling index (UCI) of each cord was determined by dividing the total number of complete umbilical vascular coils by the umbilical cord length (in centimetres). Hypocoiled group was taken as having values less than the 10th percentile and hypercoiled group with values more than 90th percentile of the mean. Antepartum high-risk factors like medical disorders like diabetes, hypertension were noted. Intrapartum factors like mode of delivery, fetal heart rate (FHR) abnormalities, meconium stained liquor (MSL), Preterm delivery, vaginal delivery or Caesarean section were noted as per proforma & analysed. New born factors like APGAR at 1 & 5 minutes, birth weight, admission to neonatal intensive care unit (NICU), and congenital anomalies when present were noted. Results: Hypocoiling had significant association with Preterm births, Maternal hypertension, Fetal distress with or without meconium stained liquor, Low birth weight, Neonatal intensive care admissions, low APGAR at 1 & 5 minutes. Hypercoiling and hypocoiling were both associated with fetal distress. Conclusion: Abnormal umbilical coiling index (UCI) has a positive relationship with maternal risk factors & adverse perinatal outcome. In the future, ultrasonographic evaluation of the umbilical cord and the umbilical cord coiling index may become an integral part of antepartum fetal assessment in high risk pregnancies.