Introduction: Perinatal hypoxia is one of the leading causes of perinatal mortality in developing countries. Birth asphyxia is an important cause of static developmental and neurological handicap both in term and preterm infants (in 3 to 13% of infants with cerebral palsy (CP) have evidence of intrapartum asphyxia). Though there are more and more studies and understanding of the mechanisms leading to birth asphyxia, early determination of tissue damages due to birth asphyxia are still lacking. Methods: This is a Hospital based Case Control study carried out in -Neonatal ICU, DEPARTMENT OF PEDIATRICS, Surat Municipal Institute of Medical Education and Research, Surat City. Study was conducted for period of 12 months and data analysis was conducted over the period of 12 months. Sample size was 56 patients of birth asphyxia admitted in NICU and compared against 56 controls admitted in NICU for some other disease. Results: .In this study, Mean UA/Cr ratio among cases was 2.58±1.15 as compared to control group where the ratio was 0.71±0.21 . This difference was statistically significant. (p<0.00001). Conclusion: Mean UA/Cr ratio among asphyxiated newborns was high and statistically significant and hence the ratio can be used as early, cost effective, simple, quick and non-invasive parameter, a supportive tool to the diagnosis of birth asphyxia using Apgar score