Both hypocoiled and hypercoiled umbilical cords are associated with adverse perinatal outcome such as intrauterine deaths, preterm delivery, repetitive intrapartum fetal heart deceleration, operative delivery for fetal distress, meconium staining and chromosomal abnormalities. The purpose of this study is to evaluate antenatal umbilical cord coiling index obtained during fetal anatomic survey in the second trimester as a predictor of adverse pregnancy outcome. The 100 patients identified with the UCI were enrolled in the study from the Anugrah Narayan Magadh Medical College and Hospital. UCI was calculated by dividing total number of coils by the total length of the cord in centimetres. The study was planned in the Department of Gynecology with Department of Radiology in Anugrah Narayan Magadh Medical College and Hospital. Our study concluded that antenatal evaluation of umbilical cord coiling could be considered as a useful tool for predicting adverse pregnancy outcome, without significantly increasing the ultrasound evaluation time. Observation of abnormal coiling patterns and thereafter interventions to reduce fetal hypoxemia can help in improving perinatal morbidity and mortality.