Abstract: Management of heart disease complicating pregnancy in a tertiary care centre is a great challenge to obstetricians and cardiologists. To know the maternal perinatal outcome of heart disease complicating pregnancies so that the quality of treatment in a tertiary care centre can be improved. Cardiac disease in pregnant women most commonly due to RHD, CHD, less commonly due to ischemic heart disease or cardiomyopathy. Though the frequency of RHD has decreased worldwide but still in developing countries like India, RHD is predominant. Admission of heart disease in pregnant women is approximately 30 of 2278 total deliveries from the month of june2018 to august2018 in MGMGH. The purpose of this study is to analyse all heart diseases in pregnancy and to characterize the clinical course, treatment and perinatal outcome in antenatal and postnatal women. Details of all antenatal or women less than 6 weeks postpartum admitted to MGMGH in the month of june to august 2018 were reviewed. Obstetric data included gestational age at the time of delivery, type, indication , location of delivery, congenital , rheumatic heart disease, operated , newly diagnosed were categorised depending on the major system involved. Out of 2278 deliveries from june2018 to august2018 in MGMGH, Trichy, 30 were heart disease complicating pregnancy. Rheumatic heart disease and congenital heart disease were more common. Operated congenital heart disease was also more common. Postnatally most of them required ICU monitoring and management. Incidence of Postpartum cardiomyopathy was very less in this study. Early anticipation of complications and close monitoring in the antenatal and perinatal period decreased maternal morbidity and mortality.