Background: The usefulness of single value of HbAlc during last trimester in pregnancies complicated by gestational diabetes in predicting perinatal outcome. The aim of the study was to anticipate and manage the difficult labor due to macrosomia and to monitor these high risk newborns closely for hypoglycemia thereby preventing the neonatal morbidity and mortality. Methods: A Prospective observational study of 80 mothers was done for a period of three years from 2015 to 2017 in Department of Obstetrics and Gynaecology, Rajah Muthiah Medical college and hospital, Annamalai University Chidambaram. HbAlc level was estimated as one time blood test in the last trimester of pregnancy. At delivery anthropometric measurements of the baby were recorded. Any difficult or non-progression of labor and ceaserian section details, NICU admission,TTN, still birth, babies going for sepsis, congenital defects,other blood parameters like hypoglycaemia, hyperbilirubinemia, polycythemia were recorded. Results: HbAlc <6.5% is defined as normal and HbAlc > 6.5% as abnormal. In Present study mothers with abnormal HbAlc levels had two macrosomic babies ,four babies with hypoglycaemia, four babies with TTN, one baby with hyperbilirubinemia, Admission to Neonatal unit was required in 7.5%. Conclusion: Maternal morbidity, perinatal morbidity and mortality are increased in women with gestational diabetes mellitus. An abnormal HbAlc in third trimester in pregnancies complicated by diabetes can predict these adverse perinatal outcome, since glycemic control in third trimester determines the perinatal outcome.