Background: Rhesus incompatibility is a preventable cause for severe neonatal hyperbilirubinemia, hydrops fetalis and still births. The prevalence of the Rh-negative blood group among Indian woman varies from 2%-5%. Despite declining the incidence of Rhesus incompatibility, due to availability of anti-D immunoglobulin, and improved antenatal care of the Rh-negative pregnant woman, it still accounts for a significant proportion of neonatal hyperbilirubinemia and morbidity. Objectives: To study the perinatal outcome in Rhesus negative Pregnancies. Methodology: This prospective observational study was conducted in a tertiary hospital. Women with Rh Negative Blood group admitted for delivery were enrolled. Baby’s Blood Group, Birth weight, TSB levels, duration of phototherapy or exchange transfusion, duration of NICU admission, and other investigations were recorded in a predesigned, pretested proforma. Conclusion: Over the 20th century, Rh isoimmunization was clinically recognized, its pathophysiology was understood, its treatment was established, and preventive measures were created to eliminate it. Awareness should be increased amongst health care providers regarding RAADP and prophylaxis after MTP, abortion, ectopic pregnancy in Rh negative blood group, and importance of Antenatal Care and importance of Rh typing in pregnancy.