Background: Abruptio placentae is one of the obstetric emergencies for both mother and fetus. Obstetrical hemorrhage is one of the main causes of maternal and perinatal morbidity and mortality. Hence, this study was conducted to find out the prevalence of abruptio placentae and potential determinants of maternal and fetal adverse outcomes at St John's Medical College and Hospital, Bengaluru, India. Methods: This is a retrospective study of 5 years (2014–2019) at St John's Medical College and Hospital. Totally, 16,082 charts were reviewed to find 140 cases with abruption. Data were collected using a structured validated questionnaire which included four parts, namely, sociodemographic details, risk factors, maternal outcomes, and perinatal outcomes. Statistical analysis was performed using IBM SPSS statistics 23.0. Results: A total of 16,082 deliveries occurred during study period, and 140 of them had abruptio placentae with prevalence of 8.7 in 1,000 deliveries. Most of the women belonged to 20–35 years of age (91.4%) and 76 (54.3%) were between 28 and 34 weeks of gestation. One-hundred and thirty-seven (97.9%) had singleton pregnancy and 77 (80%) were multigravida. Seventy-nine (54.5%) had preeclampsia. Postpartum hemorrhage was most frequently observed in maternal complication (30%). Other complications were disseminated intravascular coagulation (5%), intensive care unit (ICU) admission of mother (1.5%), and acute renal failure (9.3%). Interval between diagnosis to delivery and mode of delivery and parity index were analyzed as predictors for maternal and perinatal course, but they were not significant statistically. Significance was found for multipara and ICU admission of mother (p = 0.023). Conclusion: There is high association between antenatal complications like preeclampsia and abruptio placentae. Interval between diagnosis to delivery should not be prolonged (<24 hours). High parity index women need more attention during their antenatal period. Key messages: Newer approach of treatment with better pregnancy outcomes in mothers with abruption with risk determination in an Indian population.