Perinatal asphyxia signifies a decrease in blood or oxygen supply to the fetus before, during, or following birth. This restriction of blood or oxygen during the time around birth can result in serious physiological and neurologic effects. Objective: To evaluate the frequency of acute kidney injury among neonates with birth asphyxia presenting at tertiary care hospitals from August 2023 to February 2024. Methods: A cross-sectional study was conducted using a consecutive non-probability sampling technique. It was performed on 105-term neonates i.e., born during 37-42 weeks of gestation of either gender who presented with birth asphyxia. Statistical software (IBM SPSS 26) was used to analyze the data. Results: The mean gestational age of the neonates was 39.55 ± 1.48 weeks, 49 (46.66%) were male while 56 (53.33%) were female patients. The prevalence of acute kidney injury in our population was 11 out of 105 (10.5%). The incidence of acute kidney injury in mothers with preeclampsia is 5 (45.5%) and 6 (54.5%) for having no preeclampsia. For birth weight 1.9 to 2.5Kg 7(63.6%) we had Acute kidney injury while for those above 2.5 Kg only 4 (36.4%) had Acute kidney injury. 4 (36.4%) out of 11 acute kidney injury neonates had a gestational age of 37 to 39 weeks and 7 (63.6%) had more than 39 weeks’ gestational age. Conclusion: It was concluded that the frequency of acute kidney injury was 10.5% and no significant difference was found for other variables such as gestational age, and mode of delivery in mothers with preeclampsia history.