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Introduction - Grey platelet syndrome is a rare inherited platelet disorder characterized by moderate to severe thrombocytopenia and large dysfunctional platelets with a specific absence of ?-granules, resulting in the grey appearance on a Wright-stained peripheral blood smear. Aim and Objectives - The potential effect of pregnancy in patients with grey platelet syndrome has not been described and the outcome of such pregnancies is unknown. In this rare case report, we describe the course of pregnancy and delivery in a patient with gray platelet syndrome. Materials and methods - Mrs. X, 25 years, outside booked, Primigravida, Gestational age - 38 weeks + 1 day, hypothyroid, presented with complaints of gingival bleeding and epistaxis. On examination, numerous petechiae was noted in bilateral lower limbs. On admission, Plt - 8,000/cumm, peripheral smear showed multiple giant platelets with absence of ?-granules, diagnosis of Grey platelet syndrome made. Patient was started on intravenous corticosteroids and multiple platelets transfusion done. Serial platelets monitoring done. She had spontaneous onset of labour, fetal ultrasound revealed Breech presentation. Patient underwent Emergency cesarean section with a platelet count of 52,000/cumm. Intraoperatively, Bicornuate uterus noted with pregnancy in right horn. Fetal cord blood taken. Moderate atonic PPH noted and was managed medically. Post operative Plt - 21,000/cumm, hence multiple platelets transfusion done. Intraperitoneal drain removal done. Neonatologists noted mild to moderate thrombocytopenia in the baby. Patient was discharged after tapering to oral steroids with a platelet count of 60,000/cumm. Results and conclusion - Guidelines recommend to treat the patient with a multidisciplinary approach, involving a haematologist, a neonatologist and to plan birth in a tertiary care centre with a High Dependency Unit. Avoid regional anaesthesia if platelets count is less than 50,000/cumm under most circumstances. Serial platelets monitoring should be done. Judicious use of platelet transfusions and active management of labor should be considered.