Abstract: Due to active involvement of fetal system in regulation of amniotic fluid volume it has been identified as an indicator of intrauterine fetal status. USG has revolutionized the process of assessment of amniotic fluid thus becoming an integral part of fetal surveillance. Polyhydramnios is an obstetrical condition associated with significant perinatal morbidity and mortality. In a low resource health facility as India with poor coverage of antenatal care and malnutrition it still becomes more important to screen pregnancies for such high risk factors. The objectives of the present study were: 1. To determine the incidence of polyhydramnios by ultrasonography. 2. To evaluate its relationship with neonatal outcome. A hospital based prospective study for duration of one year. All the patients identified as having polyhydramnios according to Largest pocket diameter method. The incidence of polyhydramnios in singleton pregnancy during the study period was 1.04 %. Majority of cases (76.61%) were mild, 14.03% moderate and 9.36 % severe polyhydramnios. Congenital anomalies were present in 34 (19.88%) fetus. The commonest malformations were central nervous system 17 cases (9.94%), gastrointestinal system anomalies 9 (5.3%) and musculoskeletal 7 cases (4.1%). Anencephaly was the commonest CNS malformations. Significant association existed between severity of polyhydramnios and chances of fetus having congenital anomaly. Other fetal complications include VLBW 4.09%, macrosomia 1.75%, SGA babies 8.77%, LGA babies 9.94%, still birth 7.59%, NICU admission 20.47% , Perinatal death 16.96% and early neonatal death 9.36%. The study gives us the understanding of the impact of polyhydramnios on the fetal outcome. Our study demonstrates that careful fetal examination has to be performed when polyhydramnios is diagnosed, as congenital malformations are often associated with this condition. These anomalies if detected early timely termination of pregnancy can be done hence less physical and psychological trauma to mother.