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Introduction: The Medical Board for termination of pregnancy at GGMC, Mumbai, has handled 78 cases since July 2023, addressing fetal anomalies and maternal health risks beyond 24 weeks of gestation. Aims and Objectives: This study aims to evaluate the functioning, efficiency, and outcomes of the Medical Board at GGMC, focusing on its compliance with legal mandates and timely decision-making in complex pregnancy cases. Material and Methods: Data from 78 cases managed by the Medical Board were reviewed. The Board?s functions include examining patients, reviewing medical records, co-opting specialists, and providing opinions in Form D within three days. Terminations, if approved, were conducted within five days as per legal requirements. Cases were analyzed based on indications, decision timelines, additional investigations, and procedural outcomes. Directives from the Hon?ble High Court (WP No. 2319/2024) served as guiding principles for board activities. Results: Out of 78 cases, the Board approved terminations for 92% of pregnancies with severe fetal anomalies and/or maternal health risks. Key fetal anomalies included anencephaly, cardiac defects, and skeletal dysplasia. The remaining 8% were rejected due to insufficient indications or patient ineligibility. Average decision-to-procedure time was four days, ensuring compliance with legal timelines. Minimal complications were reported post-procedure. The Board frequently consulted external specialists for complex cases, improving decision quality. Conclusions: The Medical Board at GGMC has effectively implemented its mandate for termination of pregnancy beyond 24 weeks, ensuring ethical and timely care. Its multidisciplinary approach and adherence to legal frameworks have minimized delays and ensured positive maternal outcomes. Further streamlining of processes and addressing logistical challenges can enhance care delivery.