Background: High risk factors during pregnancy adversely affect the maternal and foetal outcome increasing perinatal morbidity and mortality. Antepartum foetal surveillance can detect foetal hypoxia and acidemia before it becomes irreversible. Non- stress test (NST) is simple and cost-effective method of antepartum foetal surveillance. The objective of the study was to analyse the predictive value of NST in evaluating perinatal outcome in high-risk pregnancies. Materials and Method: Present study was carried out on 100 high-risk pregnant women with singleton pregnancy, of more than 34 weeks period of gestation.All participants underwent prenatal non-stress testing (NST). Based on the results, the cases were categorized into two groups: reactive NST and non-reactive NST. Perinatal outcomes were then assessed and compared between the two groups. Results: The common risk factorsobserved in our study were gestational hypertension (19%), anaemia (17%), hypothyroidism (14%), pre-eclampsia (10%), oligohydramnios (10%).Around 66% of the participants had reactive prenatal NST while 34% cases had non-reactive NST. Around 41% of the infants were low birth weight in non-reactive NST group while 13.6% in reactive group. Total 20.59% babies in non-reactive NST group had low Apgar at 5 minutes requiring NICU admission while 6.06% babies in reactive NST group had low Apgar requiring admission. Conclusion: Present study reveals significant difference in perinatal outcomes in highrisk cases with reactive and non-reactive NST. NST can be used for identifying the foetuses at risk of asphyxia and avoiding unnecessary delay in intervention. It can be used as single best screening in low resource centres to screen high risk antenatal cases.