Aims and objectives: Globally congenital anomalies affect 2–3% of births and constitute the fifth largest cause of neonatal death. It is difficult to ascertain a single cause for defects as most of them have multifactorial etiology. They have a consequential impact on affected parents, their families, the health care system, and society as they are associated with long-term disability. In this study, efforts are made to determine the incidence of congenital anomalies, patterns, and epidemiological features in these mothers and to help develop strategies for patient counseling and management in our setting. Materials and methods: Medical records of one year were reviewed and all women who delivered after 12 weeks of gestation with congenital anomalies were studied. Their demographic data, significant history, investigations, and management details were documented and analyzed. Results: In 63 cases congenital anomalies were noted among 8,529 birth records. Incidence was 7.3 per 1,000 live births 54% were 12–28 weeks, central nervous system (CNS) anomalies were most common (42.5%), followed by cardiovascular system (CVS) anomalies (17.8%). Among CNS anomalies neural tube defects form the major proportion followed by hydrocephalus. Anencephaly is the most common neural tube defect. Conclusion: Survivors of congenital anomalies might have lifelong physical, mental, visual, and auditory disabilities if not managed appropriately, which can negatively affect the human and economic life of the person concerned, as well as their families and communities. Clinical significance: It is important to promote national programs for mitigating congenital anomalies, research to discover etiology, and maintain of national registry for formulating protocols for better counseling and management options. Strengthening the community-level strategies to decrease the incidence of NTD by way of folic acid supplementation.