To evaluate the cause of NIHF cases referred to a tertiary referral center and to analyze the outcome. A total of 130 cases of fetal hydrops registered during eight-year study period were reviewed. Antenatal ultrasound, blood investigations and postnatal fetal examination were done, and outcome was noted. Out of 130 cases of NIHF, antenatal ultrasound showed the presence of structural malformations in 94/130 (72.3%), cardiac abnormality was the most common (34/130, 26.1%) and cystic hygroma was seen in 15/130 (11.5%). Chromosomal abnormality was observed in 15(11.5%) cases, and Doppler US showed anemia in 4/130 (3.1%) cases only. Live born were 25 (12.9%), and rest all were stillborn or abortion. Later mean gestational age of presentation (p=0.0001), presence of gastrointestinal malformation (p=0.0001) and absence of structural malformations (p=0.0441) were factors significantly associated with live birth; the presence of cystic hygroma (p=0.0431) or structural heart defect (p=0.007) was significantly associated with poor outcome. Fetal anemia was not a common cause of NIHF in the study population. The early onset of hydrops and presence of structural malformation carry a graver prognosis; type of structural defect also has bearing on outcome.