ackground:Referral of high risk antenatal mothers plays a pivotal role especially in a developing country like Abstract India, to reduce the feto-materal mortality. Methods: Aprospective observational study was conducted in Medical College and Hospital, Kolkata from 1st May 2014 to 30th April 2015 to include 100 obstetric referral cases which required admission. Results: 47% were in the age group of 20-25 years (mean age: 23 years).Majority of patients (57%, n=57) were primigravidas and came from rural areas (77%, n=77) .70%(n=70) of study population did not have any prior antenatal checkup.34% (n=34) of total referrals were from state govt. hospitals of neighbouring districts followed by 27% (n=27) from rural hospitals. Most of the referred patients were in labour at the time of referral (87%,n=87) .40.2% presented with medical/obstetric complications. The most common indication for referral was patients with previous caesarean section (23% ,n=23), PROM/PPROM (15%,n=15), medical disorders complicating pregnancy (8%,n=8).69% of referred patients required surgical management in the form of LSCS (61%, n=61) and instrumental deliveries (8%, n=8).There was one maternal mortality. Perinatal mortality rate was found to be 11.2% (n=12).Conclusion: 56% (n=56) of referrals to our hospital were unjustified, emphasizing the need for development of strict referral protocols. KEYWORDS: Referrals, Obstetric, Tertiary