This prospective cross sectional study was conducted in a tertiary hospital in Northern India. The objective of the study was to investigate the utility of recording certain fetal biophysical variables at or near term in high risk pregnancy for predicting the fetal outcome. A fetal biophysical profile score was used for predicting the outcome. The scoring system utilized following variables: non stress test, fetal breathing movement, fetal movement, fetal tone and amniotic fluid volume. One hundred and fifty four pregnant women attending a high risk pregnancy clinic were consecutively included in the study. At a cut off score < or = 4, sensitivity of the scoring system was 12.5% and specificity 99.23%. At score < or = 8, corresponding figures were 70.83% and 91.53%. As compared to each individual variable, the positive predictive value for abnormal perinatal outcome improved considerably after combining all the variables. The negative predictive value for normal perinatal outcome did not improve. Though biophysical profile scoring is used as a valuable adjunct in caring high risk fetuses, a simple and more practical screening test should be sought for. The cost-benefit analysis of such tests should also be performed.