Aim and objective: To correlate the association between postnatal umbilical cord coiling index (UCI) and perinatal outcome. Materials and methods: This is a cross-sectional study conducted on 220 booked singleton pregnant women with cephalic presentation immediate post-delivery. Both vaginal and cesarean deliveries were included. Umbilical cord coiling index was calculated and the variables assessed were gestational diabetes mellitus (GDM), anemia, hypertensive disorders, oligohydramnios, polyhydramnios, meconium-stained liquor, mode of delivery in the mother and preterm, fetal growth restriction (FGR) and neonatal intensive care unit (NICU) admissions in the fetus. Results: Hypercoiled group or UCI >90th percentile showed a significant increase in cases of FGR (p-value 0.007), GDM (p-value 0.001), and polyhydramnios (p-value 0.0001). Hypocoiled group or umbilical cord coiling index (UCI) <10th percentile showed a significant increase in cases of preterm (p-value 0.01), hypertensive disorders (p-value 0.0001), meconium-stained liquor (MSL) (0.0003), and NICU admission (p-value 0.0001). The study did not reveal any significant changes with regard to mode of delivery, anemia, or oligohydramnios among the three groups (hypercoiled, hypocoiled, and normocoiled). Conclusion: The present study shows that the umbilical cord coiling index is a useful predictor of adverse perinatal outcomes. Cases with abnormal UCI (hypercoiling and hypocoiling) had a higher incidence of complications such as FGR, GDM, polyhydramnios, hypertensive disorders, MSL, and NICU admission. There is a huge arena for research in this field and routine screening of UCI should be considered antenatally.