Fetal death/Intra uterine death (IUD) is a significant adverse pregnancy outcome, particularly prevalent in low- and middle-income countries. It is also a good indicator of quality of healthcare available. Fetal autopsy is often required to determine the cause of intrauterine death or miscarriages, provide recurrence risk, and is known to alter the final diagnosis and genetic counseling. Aim: To study the maternal and fetal factors in fetal autopsy lesions. To know the prevalence of various fetal abnormalities in IUD. Material and methods: The present study was a retrospective observational study conducted in the Department of Pathology at Dr. BVP Rural Medical College, Loni, over a duration of 5 years. A total of 78 cases were included, with data collected on the mother's age, gestational age, fetal gender, weight, and other relevant details, alongside records of fetal autopsies. Special attention was given to identifying organ abnormalities in the fetuses. The collected data was compiled in Microsoft Excel, and the analysis was carried out using Openepi version 3.2.1 software. Results: The study found that mean maternal age was 24.8+ 4.5 years, ranging between 18 to 38 years. Mean gestational age was 21.7 +4 weeks. It was seen that among total 78 cases, 40 were males, 30 were females, 6 fetuses were macerated and 2 fetus gender was ambiguous. Conclusion: The study shows a varied distribution of fetal characteristics, with male fetuses being more common and cardiac abnormalities being the most prevalent. These findings emphasize the diverse nature of fetal lesions and their potential effects on fetal development, influenced by gestational age and maternal conditions.