Umbilical cord prolapse is an uncommon but critical obstetric emergency characterized by the descent of the umbilical cord through the cervix alongside or past the presenting fetal part following rupture of membranes. This condition poses a significant risk of acute fetal hypoxia due to cord compression, which can rapidly lead to fetal distress, neurological injury, or perinatal death if not promptly managed. Predisposing factors include malpresentation, prematurity, multiple gestation, polyhydramnios, and iatrogenic interventions such as artificial rupture of membranes. Clinically, umbilical cord prolapse is suspected when there is sudden fetal bradycardia or variable decelerations on cardiotocography and may be confirmed by visualization or palpation of the cord during vaginal examination. Immediate management focuses on relieving cord compression, maintaining uteroplacental perfusion, and expediting delivery—most commonly by emergency cesarean section unless vaginal delivery is imminent. Preventive strategies include identification of high-risk pregnancies and cautious intrapartum management. Early recognition and rapid multidisciplinary intervention remain pivotal in improving perinatal outcomes associated with umbilical cord prolapse.