Introduction: Anemia is one of the most prevalent nutritional deficiency problems afflicting pregnant women. Anemia that complicates pregnancy threatens the life of both the mother and the fetus. Nowadays, maternal anemia is considered as a public health problem in the world, especially in developing countries. Pregnancy increases considerably the iron needs in a mother. Iron deficiency is the most common cause for anemia during pregnancy.Aims and objectives: To assess the association of maternal anemia with perinatal outcomes. To assess the association of anemia with postpartum haemorrhage, puerperal sepsis, venous thrombosis, subinvolution of uterus, lactational failure, delayed wound healing, maternal morbidity and mortality. To determine the relationship between maternal anemia during pregnancy and intrauterine death, IUGR, infant low birth weight, APGAR scores, preterm birth, stillbirth, neonatal morbidity and mortality.Methods: A prospective observational study was conducted on 100 women who attended antenatal OPD, out of which 50 women diagnosed with iron deficiency anemia and 50 women who are non anemic and delivered at kamineni institute of medical sciences, narketpally from january 2022 to june 2022. Women whose age > 19 years and < 36 years, women with multiple gestation, gestational hypertension, pre-eclampsia, oligohydramnios, gestational diabetes mellitus, hypothyroidism, previously known case of hemolytic anemia, hemoglobinopathies such as thalassemia, sickle cell anemia, chronic renal disease, chronic liver disease, aplastic anemia and women who did not give consent to participate in the study are excluded from the study. Results: In this study of 50 anemic patients, 10 of them had mild anemia (20%), 17 of them had moderate anemia (34%), 19 of them had severe anemia (38%), 4 of them had very severe anemia (8%). Distribution according to maternal outcomes out of 50 patients, was 17 patients (34%) had IUGR, 16 patients (32%) had preterm delivery, 13 patients (26%) had delayed wound healing, 9 patients (18%) had lactational failure, 2 patients (4%) had intrauterine death. There are no cases of postpartum haemorrhage, puerperal sepsis and no maternal death. In this study of 50 patients, distribution according to neonatal outcomes was 20 patients (40%) had low birth weight, 19 patients (38%) had low APGAR scores, 7 patients (14%) had neonatal sepsis and no cases of neonatal anemia and neonatal death.Conclusion: Anemia is significantly associated with adverse maternal and neonatal outcomes and as the severity of anemia is increased, its adverse effects are even worse. Routine iron and folic acid, micronutrient supplementation regularly and whenever indicated parenteral iron infusions or blood transfusions must be done during pregnancy which prevents such adverse outcomes and has beneficial effects on the pregnancy outcome. Therefore, it is necessary for identification of anemia antenatally, prompt treatment for correction of anemia and measures to reduce the incidence of anemia in pregnancy to prevent adverse maternal and neonatal outcomes.