Abstract : Macrosomia is described as a newborn with excessive birth weight. Fetal macrosomia has been defined in several different ways, including the birth weight of 4000– 4500 gm. A diagnosis of fetal macrosomia can be made only by measuring birth weight after delivery; therefore, the condition is confirmed only after delivery of the neonate. Fetal macrosomia is encountered in up to 10% of deliveries. The aim of the study is to find the rate of prevalence of fetal macrosomia and its associated risk factors in pregnant women and secondary objective is to find out the maternal and neonatal complications occurring at the time of delivery. This was a retrospective study conducted at the O&G department of Hospital Sultan Abdul Halim, Sungai Petani, Kedah, Malaysia. All the pregnant women admitted to the O&G ward were included in the study. A total of 5763 women delivered during the period of January 2020 to August 2020. Study groups include O&G patients who attended the inpatient department. Data of the patients were collected by using a pre-designed data collection form. Patient’s demographic characteristics and pregnancy data were collected from the patient’s folder in the database system. The collected data was then transferred and descriptive analysis and chi-squrare test was used to see whether there is any statistically significant association between macrosomia and risk factors, neonatal, and maternal complications. Among 5763 deliveries, 46 were macrosomic babies, all of them (100%) were Malay patients. The prevalence of macrosomic babies was less than 1%, which is 0.798%. Diabetes, hypertension, obesity, parity, and previous macrosomia are found to be the maternal risk factors of macrosomia. The highest percentage of maternal complications was 37% having perineal tears, followed by anemia in pregnancy (21.7%), postpartum hemorrhage (2.2%), and uterine fibroid (2.2%). Most of the babies had hypoglycemia (8.7%) and pneumonia (6.5%). Other neonatal complications are such as clavicle fracture (4.3%), incomplete Moro reflex (4.3%), patent ductus arteriosus (4.3%), and undescended testes (4.3%). The prevalence of macrosomic babies in this certain tertiary care center is less. However, extra care needs to be taken as there are maternal and neonatal complications that can be serious. The advice of doctors on the mode of delivery for macrosomic mother need to be taken to ensure safe delivery.