Introduction: Infertility has become a significant social and medical concern affecting couples worldwide. Over decades, assisted reproductive technique has become a boon for couples to help them with conception. Despite the widespread clinical use and success of In vitro fertilization, its effects on pregnancy, maternal and fetal outcomes are still contentious. With a rise in concerns over increased risk of adverse maternal and fetal/neonatal outcome, this retrospective study was designed with an aim to study and compare the maternal and fetal outcomes in IVF pregnancies versus spontaneous conception. Methods: This is a retrospective cohort study. After taking informed and written consent, 100 patients conceived by IVF/ICSI with frozen embryo transfer are taken as cases and 100 patients with spontaneous conception who delivered during this period as controls. Data was analyzed using chi square test and results expressed by p value. p value less than 0.05 was considered as significant. Results: Mean age among study group was 28.59 ±4.74 years and in control group was 24.81±4.77 years with significant p value of <0.001. Incidence of maternal and fetal complications like multiple pregnancy (21% vs 6%), PIH (20% vs 9%), preterm (25% vs 13%) deliveries and intrauterine growth restriction (16% vs 11%) was significantly higher in study group compared to control group with p value of <0.05. no statistically significant differences were found in the incidence of GDM (7% vs 3%), spontaneous abortions (18% vs 8%), IHCP (5% vs 6%), anemia (9% vs 14%), blood transfusion (7% vs 9%), PROM (8% vs 13%), APH (2% vs 6%), sudden IUFD (1% vs 2%), PPH (4% vs 7%) and surgical site infection (3.7% vs 13%) among two groups. Significant higher low birth weight rate was noted among study group (44.44%) compared to control group (19.56%). No statistical significance was established regarding nicu admissions and cause of neonatal admission among two groups. Conclusion: In our study, we concluded that IVF conceived pregnancies are associated with higher maternal and neonatal complications compared to spontaneously conceived pregnancy. And we emphasized on need for shift of trend towards choosing fresh embryo transfers and natural cycle stimulated cycles instead of frozen embryo transfer whenever possible with single embryo transfer and focusing on attaining a healthy singleton pregnancy.