Introduction: Embryo culture allows us to culture embryos to the blastocyst stage. Prolonging the duration of culture to day 5 allows chromosomally competent embryos to develop to the blastocyst stage and permits selection of embryos that have the potential for continued development under embryonic genomic control. Objective: To evaluate the efficacy of blastocyst transfer in comparison with cleavage stage transfer. Methods: A randomized, prospective study was conducted in International Fertility Center, Delhi, India on 300 patients aged 25‑40 years undergoing in‑vitro fertilization (IVF)/ intra‑cytoplasmic sperm injection (ICSI) cycle from March 2019 and February 2020. When three or more Grade‑I embryos were observed on day 2 of culture, patients were divided randomly into two study groups, cleavage stage transfer and blastocyst transfer group having 150 patients each. Primary outcomes evaluated were, Clinical pregnancy rate and Implantation rate. The results were analyzed using proportions, standard deviation and Chi‑square test. Results: Both the groups were similar for age, indication and number of embryos transferred. Clinical pregnancies after blastocyst transfer were significantly higher 66 (44.0%) compared to cleavage stage embryo transfer 44 (29.33%) (p< 0.01). Implantation rate for blastocyst transfer group was also significantly higher (p< 0.001). Conclusion: Blastocyst transfer having higher implantation rate and clinical pregnancy rate lead to reduction in multiple pregnancies.