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Introduction: Water birth is a natural birthing technique, where the expectant mother gives birth in a warm water tub or pool. Aims and Objectives: This study aims to find out the maternal and fetal outcome following underwater delivery at tertiary care hospital. Material and Methods:Pregnant woman were provided information about all alternative birthing positions and those opting for underwater delivery were provided facility of underwater delivery in birthing tub.All precautions were taken and only low risk pregnant women as per inclusion criteria were delivered underwater. Maternal and fetal outcome were analysed in 180 women who had underwater delivery in 10 months period. Women?s satisfaction was assessed on a 5-point Likert scale. Results: Among 180 mothers,18% were primigravida and 82% were multigravida, birthweight of the babies was below 2.5kg in 62% and above 2.5kg in 32% babies. Average duration of second stage was 32 minutes, average duration of third stage was 8 minutes. Birth asphyxia and third stage complications were not observed in any case. Incidence of 1st and 2nd degree perineal tear was 3%. Average satisfaction score of women was 4.7 on 5-point Likert scale. Conclusion:Underwater delivery revealed advantages such as labour pain relief, reduced risk of obstetric interventions, soothing environment and smooth delivery of baby. Babies born under water did not suffer from any complications like aspiration, birth trauma, lower APGAR score, neonatal infections or increased morbidity or mortality. In women with uncomplicated pregnancy the risks are rare. Healthy babies have diving reflex which helps infant to hold breath underwater.