Background: Perinatal asphyxia is a major cause of neonatal and childhood morbidity and mortality and has been associated with neonatal death, Hypoxic Ischemic Encephalopathy (HIE), seizures, intraventricular hemorrhage, cerebral palsy and delayed development. Objective: To determine umbilical arterial blood gas parameters in term normal neonates and in neonates with evidence of fetal distress. To study the association of umbilical arterial pH with Apgar score, intubation, seizures, Hypoxic Ischemic Encephalopathy and neonatal mortality. Methodology: This is a prospective case control study including term babies born in SDM College of Medical Sciences and Hospital, Dharwad, from October 2018 to September 2019. Results: The mean umbilical arterial blood gas parameters among cases were, pH of 7.06, PCO2 67.03mmHg, PO2 22.85mmHg, HCO3- 17.35mEq/l, Base excess -11.89mmol/l and O2 saturation of 22.15%. The mean umbilical arterial blood gas parameters among controls were, pH 7.27, PCO2 48.31mmHg, PO2 18.31mmHg, HCO3- 22mEq/l, Base excess -4.86 mmol/l and O2 saturation of 27.75%. Decrease in umbilical arterial pH among cases was associated with low Apgar score (36.66%), intubation (28.33%), seizures (16.67%), HIE (36.67%) and mortality (6.7%). Among controls incidence of low Apgar score was 8.33%, intubation was 3.3%, seizures 3.3% and there were no neonates with HIE and mortality. Conclusion: This study shows that the “Pathologic acidemia” is indicated by pH <7.00 rather than <7.20, lay down by ACOG. Decrease in umbilical arterial pH among cases was associated with increased risk of intubation. However, decrease in umbilical arterial pH was not associated with increased risk for seizures, HIE and mortality.