Background: In placental mammals, the umbilical cord is a conduit between the developing embryo or foetus and the placenta. Present work was done to study the association of umbilical coiling index and perinatal outcome.Methods: One hundred umbilical cords were examined. The umbilical coiling index was calculated, by dividing the total number of coils by the total length of the cord in centimetres. The umbilical coiling index <10th percentile and >90th percentile was considered as hypocoiled and hypercoiled, respectively. The outcomes measured in terms of birth weight, Apgar score, meconium staining, Intrauterine growth restriction, gestational age at birth and Neonatal intensive care unit admission.Results: The mean umbilical cord length was 51.2 cms, mean number of coils 10.8 and mean umbilical coiling index 0.2. 80 umbilical cords showed normocoiling, 10 hypercoiling and 10 had hypocoiling. Meconium stained liquor was present in 80%, 37.5% and 20% in hypocoiling, normocoiling and hypercoiling group, respectively, with p valve of <0.05. 40% of babies with hypocoiling cords had Apgar at 1 minute <4 and apgar score at 5 minutes <7. Intrauterine growth restriction and low birth weight babies were significantly higher in hypercoiling group. Neonatal intensive care unit admission was higher (40%) in both hypocoiling and hypercoiling group as compared to normocoiling group (10%).Conclusions: Present study thus shows abnormal coiling index is associated with adverse perinatal outcome.