Background: Birth asphyxia is one of the leading causes of neonatal mortality in India. Hypoxic-ischemic encephalopathy (HIE) is the neurological manifestation of systemic hypoxia in new-born. 20-25% of asphyxiated babies who exhibit severe HIE, die during the new-born period. The most commonly used diagnostic and prognostic index to evaluate asphyxia in neonates is APGAR score but alone it is not useful to ferret out neurological outcome. Now-a-days uses of biomarkers enable the clinicians to screen infants for brain injury. We conducted this study to evaluate the role of UUA (urinary uric acid)/Cr (creatinine), which is an early biomarker, in diagnosing and predicting the outcome in perinatal asphyxia.