The elderly primigravida is a woman having her first pregnancy at the age of 35 years or more. The pursuit of educational and career goals, late and second marriages, financial concerns, infertility, advances in assisted reproductive technologies and effective birth control are believed to have contributed to the shift in childbearing patterns among older women. Aims and Objectives: (a) To find out the incidence of elderly primigravida amongst the pregnant population attending MKCG Medical College & Hospital, Berhampur; Odisha. (b) To assess the maternal outcome in terms of mode of termination of pregnancy & maternal complications.(c)To assess the fetal outcome. Materials and Methods: This is a prospective observational study conducted in the Department of Obstetrics & Gynaecology of MKCG Medical College, Berhampur; Odisha, India during the period from May 2021 to June 2023. All the cases were selected from cases attending OPD and labour room of this department in respect to inclusion and exclusion criteria. Inclusion criteria: all primigravida with singleton pregnancy more than 35 yrs and exclusion criteria: (a) all multigravida (b) cases having twin pregnancy (c) cases having major cardiac, respiratory and renal diseases. After selection of cases details history including obstetric profile were taken followed by complete clinical examination including baseline investigation. Results: The current study included 102 cases of primigravidas aged 35 years or more from May 2021 to June 2023. Out of 102 cases, 74 cases (72.54%) conceived within 1-5 years of marriage among which 71 cases (69.60%) belonged to 35-39 years of age and 3 cases (2.94%) belonged to > 40 years of age. There were 23 cases (22.54%) conceived within 6-9 years of marriage among which 22 cases (21.56%) belonged to 35-39 years of age and one case (0.98%) belonged to > 40yrs of age. Only 5 cases (4.90%) conceived after 9 years of marriage of which all cases (4.90%) belonged to 35-39 years age. Among the antenatal complications, 27 cases (26.47%) had hypertensive disorder of pregnancy (HDP) which included 18 cases (17.64%) of pre eclampsia, 8 cases (7.84%) of gestational hypertension and one case (0.98%) of ante partum eclampsia, 12 cases (11.76%) had FGR, 6 cases (5.88%) had oligohydramnios and 2 cases (1.96%) of each had abruption, GDM and polyhydramnnios. Among the cases of elderly primigravida, normal vaginal delivery, caesarean section and instrumental delivery occurred in 28 cases (27.45%), 68 cases (66.66%) and 6 cases (5.88%) respectively. Among the caesarean section cases, 26 cases (25.49%) were undergone elective caesarean section and 42 cases (41.18%) were undergone emergency caesarean section. Among the newborns, majority of babies i.e 61 babies (59.80%) had birth weight > 2.5kg and 41 babies (40.20%) had low birth weight babies (<2.5kg). Conclusion: So this high risk group requires special care like preconception counseling, early booking, close supervision in the antenatal & intra natal period and appropriate intervention for an optimum outcome.