Background: In babies with perinatal asphyxia, hypoxia and ischemia can cause damage to almost every tissue and organ of the body and kidneys are one of the most commonly affected organs. Renal insufciency may occur within 24 hours of a hypoxic ischemic episode leading to variable degree of kidney injury. Serum electrolyte levels are also found to be signicantly affected in perinatal asphyxia.Aims & Objective: Estimation of acute kidney injury and its correlation with severity of perinatal asphyxia and assess electrolyte imbalance in term neonates with perinatal asphyxia. Materials and Methods: It is a prospective observational study conducted at a tertiary care centre during the study period. Renal parameters and serum electrolytes of asphyxiated newborns were evaluated and kidney injury was classied on the basis of AKIN criteria. Results: Among 175 newborns with perinatal asphyxia, 29.7% had HIE1, 14.3% of them developed HIE 3 while maximum of them (56%) had HIE stage 2. It was observed that 38.3% of the enrolled babies developed acute kidney injury. 14.9 % of cases had stage 1 AKI, stage 2 acute kidney injury was found in 16.6 % of cases and stage 3 acute kidney injury developed in 6.8 % of cases. Among total babies, 77.1% of the babies had hyponatremia while 9.7% of the babies had hyperkalemia. Out of 160 babies who were followed till outcome, 90% discharged while 10% of them died. Conclusion: Perinatal asphyxia is an important cause of renal dysfunction which plays an important role in mortality and morbidity of the asphyxiated newborn. Early diagnosis and management of AKI in babies with perinatal asphyxia can improve their outcome. Electrolyte disturbance in the form of hyponatremia and hyperkalemia is also an important derangement in babies with birth asphyxia which needs accurate and careful management for better outcome.