Birth prevalence of congenital anomalies in developing countries is actually underestimated due to poor registry, lack of diagnostic techniques and their reliability. Like other low and middle income countries, still, congenital anomalies are not considered as a major problem in India. But literature search reveals that India has the highest number of children with birth defects. Hence, based on the above literature findings, present study was planned to generate a systematic data on the magnitude of congenital anomalies, their pattern of prevalence, healthcare impact and impact on neonatal health. Prevalence studies give an idea about the pattern of occurrence of anomalies in different places, changes over a period of time and also give some clues to identify the aetiology. The study was planned in Department of Paediatrics, Darbhanga Medical College and Hospital, Laheriasarai. 100 neonates identified with birth defects from May 2017 to Feb 2018 were enrolled in the present study. Approval of the institutional ethical committee was taken prior to conduct of the study and all participants were duly informed and consent taken. The aim and the objective of the present study was conveyed to parents of the neonates. From present study it has been concluded that congenital anomalies in new-borns were significantly associated with fetal factors like still birth, prematurity and low birth weight. Their incidence can be reduced by following prevention strategies including primary, secondary and tertiary levels of prevention. These strategies can be applied at various stages of pregnancy that is Preconception, Antenatal and Postnatal period.