Anemia is the most preventable cause of maternal and perinatal mortality and morbidity. This study was carried out to evaluate the maternal and perinatal outcome in pregnancy with severe anaemia. This study was carried out in 420 pregnant women in labour. Patient were divided into Group – A (Haemoglobin<7.0gm/dl, n=210 women) and Group – B (Haemoglobin ≥ 11 gm/dl, n=210 women). Their maternal and perinatal outcome, mode of delivery and postpartum complications were noted and analysed. The maternal and perinatal complications were significantly more in Group – A than in Group – B , Preterm labour (42.8% v/s 14.3%), Preeclampsia (16.1% v/s 3.3%), Sepsis (3.8% v/s 0% ), CHF (1.4% v/s 0% ), Low birth weight(55.2% v/s 9.1% ), Still birth (10.9% v/s 3.30%), IUGR (9.0% v/s5.2 % ), Birth Asphyxia (10.9% v/s 0.9% ) and Admission in NICU ( 14.7% v/s9.5 % ). Severe anaemia was associated with significantly more maternal and perinatal complications which mandate screening for nutritional deficiency anaemia in pregnant women and also to treat those cases to improve maternal and perinatal outcome.