Introduction: Perinatal asphyxia contributes greatly to neonatal mortality and morbidity. In developing countries, the need for risk factor assessment in perinatal asphyxia is obvious because of the high birth rate and limited perinatal resources1. Objectives: To assess risk factors of birth asphyxia in babies born at LUH Hyderabad. Study design: Descriptive. Setting: Department of Peadiatric medicine and department of Gynecology & obstetric, Liaquat University Hospital, Hyderabad. Duration with dates: 2 years (01-06-2007 to 31-05-2009) Subjects and methods: In this study 300 patients were analyzed/admitted at Paediatric unit II as case of birth asphyxia on basis of delayed cry after birth along with APGAR score of =3 at 1 and 5 minutes after birth has been evaluated for risk factors of birth asphyxia. Data of each patient was collected on preformed Proforma and analyzed on SPSS version 10. Frequency and percentages of different variables were computed. Mean and standard deviation was computed for quantitative variables like age of baby, weight of baby. Chi-square test was applied to compare different proportion at level of significance of p <0.05. Results: Risk factors in this study leading to birth asphyxia with decreasing frequency are irregular antenatal visits (46%), decreased inter pregnancy interval (28%), prolonged rupture of membrane (40%), prolonged labor (40%), previous bad obstetrical history (30%), anemia (24%), preeclampsia (17%) and antepartum hemorrhage (13%). Conclusion: Burden of birth asphyxia in our society is mainly increased due to improper perinatal care, late diagnosis and referral of high-risk pregnancy to proper place.