Perinatal asphyxia is one of the major cause of neonatal mortality and morbidity. It is an important cause of static developmental and neurological handicap in terms. So early detection and treatment can significantly reduce morbidity and mortality. Based on above clinical findings the present study was planned for study of changes in levels of uric acid & creatinine levels in the neonates suffered from neonatal asphyxia. The present study was planned in Department of Pediatrics, Government Medical College, Bettiah, West Champaran, Bihar. Total 100 cases were enrolled in the present study. Out of the total enrolled cases 50 cases of suffered from the neonatal asphyxia were studied under Group I and another 50 cases without any complication were studied under Group II as control cases. The spot urinary sample within 24 hours is to be collected and is analyzed in hospital laboratory. Urinary uric acid was estimated by auto analyzer by spectrophotometric uricase method. Urinary creatinine was estimated in same above instrument by using modified kinetic Jaffe’s method. The data generated from the present study concludes that urinary uric acid/ creatinine ratio is significantly high in babies with birth asphyxia and there is significant negative linear correlation between urinary uric acid/ creatinine ratio and Apgar score at 1 min, 5 min and 10 min among asphyxiated babies. The urinary Uric Acid/Creatinine ratio in combination with the APGAR score and other scoring tools can contribute to early decision making on the level of care that infants require.