BACKGROUND Perinatal asphyxia can lead to hypoxic ischaemic encephalopathy (HIE). The mortality due to hypoxic ischaemic encephalopathy is as high as 28.8% and morbidity is 30% of surviving newborn due to hypoxic ischaemic encephalopathy. Aims and Objectives-To study the plasma biochemical phenomena in neonates with hypoxic ischaemic encephalopathy in relation with severity of HIE. MATERIALS AND METHODSIt is a hospital-based prospective study done in tertiary care hospital in SCB Medical College Hospital and SVP PG Institute, Cuttack from November 2015 to October 2017. RESULTSThe babies with perinatal asphyxia develop hyponatraemia, hypocalcaemia, hyperkalaemia, high serum urea and creatinine, high serum ALT, AST, ALP, decrease in serum albumin and increase in Prothrombin time in proportion to the severity of asphyxia. CONCLUSIONA significant number of babies with birth asphyxia and deranged biochemical parameters either died or discharged with severe neurological sequelae. It can be concluded that deranged biochemical parameters are early indicators of poor outcome. Studies should be held on the effects of early correction of these metabolic derangements with their outcomes, so that it may invent a new horizon of treatment for birth asphyxia babies.