Objective: To find out whether amniotic fluid lamellar body concentrations (LBC) can predict neonatal respiratory distress syndrome (RDS) Materials and methods: Amniotic fluid was obtained at the time of cesarean section was sent to the laboratory for lamellar body concentrations in amniotic fluid. The lamellar body concentrations were analyzed and correlated with the incidence of RDS. Results: The incidence of RDS at different gestational age with an LBC cut off of 41,500 was studied. Among 220 patients studied, Respiratory distress was seen in 53 (24.09%) of patients. There is a significant correlation between decreasing lamellar body count in preterms and incidence of RDS. LBC count has a sensitivity of 92.7 %, the specificity of 90 %, a positive-predictive value of 73% and a negative-predictive value of 98% in predicting respiratory distress syndrome. Conclusion: LBC count in the current study is a cheap, easy and reliable method of assessing fetal lung maturity. Abbreviations: RDS: Respiratory distress syndrome; LBC: Lamellar body count; FLM: Fetal lung maturity. Ethics approval: Ethical committee clearance was obtained on 15/9/2011 before the start of the study from Manipal University ethical committee and Kasturba Hospital, Manipal under reference number IEC248/2011.