Intrauterine passage of meconium may be due to fetal hypoxia, or it may simply indicate a normal gastrointestinal tract maturation. Umbilical cord blood pH is the best available criterion for detecting fetal hypoxia and making appropriate decisions about care after birth.To determine the correlation of umbilical cord arterial blood pH with meconium stained liquor and neonatal outcome. To determine whether the mode of delivery had any influence on the occurrence of acidemia in the neonate complicated with meconium stained liquor. A prospective observational study was conducted for a period of 6 months. Immediately following delivery in pregnancies complicated with meconium stained liquor, blood was drawn from the umbilical artery and sent for arterial blood gas (ABG) analysis. Neonatal outcome parameters and mode of delivery were then recorded in a pre-designed proforma. There was a statistically significant correlation between abnormal pH (acidosis) and thick meconium stained liquor. Neonatal outcome parameters like Apgar scores at 1 minute and 5 minutes, intravenous antibiotic administration, NICU admission and oxygen supplementation were statistically significant when correlated with the pH level.The degree of meconium thickness independently correlates with the composite adverse neonatal outcome. Cases with meconium stained liquor should be monitored vigorously with timely interventions and proper neonatal resuscitation, especially the ones with thick meconium stained liquor, in order to prevent adverse neonatal outcome.