Thrombocytopeniaissecond to anaemia as the most common hematological abnormality during pregnancy. Accurate etiological diagnosis is essential for optimal therapeutic management and thus can prevent maternal and fetal morbidity and mortality. Aim &Objective:To study the clinical profile, maternal and perinatal outcomes in thrombocytopenic antenatal patients. Design:This Prospective observational study design was carried out in the department of obstetrics and gynecology at Chalmeda Anand Rao Institute of Medical sciences Karimnagar, over a period of 18 months from October 2020 to April 2022. Materials And Methods:All the pregnant women who attended antenatal OPD at Chalmeda Anand Rao Institute of Medical Sciences were tested for thrombocytopenia. 70 pregnant women with thrombocytopenia, platelet count lessthan 150x 109 /L and 70 pregnant women with normal platelet count were recruited into the study and the maternal & Fetal outcomes of both groups were studied and compared. Results: Gestational thrombocytopenia is the most common etiology (57.1%). Incidence of thrombocytopenia due to severe preeclampsia and Hemolysis, Elevated Liver enzymes, Low Platelet (HELLP) syndrome in the study group was 28.5% and 8.5% of them had medical cause like malarial or dengue fever. Major causes were gestational thrombocytopenia (GT), Idiopathic Thrombocytopenic Purpura (ITP), Preeclampsia, HELLP syndrome, Malaria, and Dengue. Maternal complications due to bleeding tendencies like placental abruption, Postpartumhemorrhage were evident in the study population. Fetal complications were significantly higher in the study group. Early neonatal thrombocytopenia depended on etiology rather than severity of maternal thrombocytopenia. Conclusions:Outcome of pregnancy with moderate to severe thrombocytopenia dependsmainly on the etiology of thrombocytopenia. Adverse outcomes are especially seen with pregnancy complicated by preeclampsia and HELLP syndrome. Fetomaternal outcome is favorable in gestational thrombocytopenia. Thus, accurate etiological diagnosis is essential for optimal therapeutic management.