Birth asphyxia occurs world wide and remains a serious cause of morbidity of the newborn. Its incidence and associated sequelae have remained high in the developing world with an attendant high mortality as compared to more affluent societies or the developed world. We have attempted in this review, to proffer an assessment, prevention strategies and detailed management of birth asphyxia with particular reference to the tropics and sub-tropics. A continuous surveillance of this problem is highly essential and so is the strict use of facilities at our disposal; clinical screening and partography for example, as these could keep a rising incidence in check.