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Background: Echocardiographic evaluation is conducted as a part of routine antenatal screening in India. We conducted a study to evaluate if routine echocardiographic screening in asymptomatic patients with no self-reported symptoms and no abnormalities on clinical examination would alter the intrapartum and peripartum care. A single centre retrospective review of case records and echocardiographic images of 472 asymptomatic patients, conducted as a part of routine antenatal screening were reviewed by 2 independent cardiologists. The study excluded pregnant patients with known cardiovascular diseases (CVD) and those with clinical risk factors. Results: The rate of newly diagnosed CVD in the study was 3.6%. Acquired heart disease was found in 2.7% of the study population which comprised Rheumatic heart disease (RHD) in 0.42%, mitral valve prolapse (MVP) without mitral regurgitation (MR) in 0.84%, and MVP with MR in 1.48%. Congenital heart disease (CHD) was incidentally detected in 0.84% of patients comprising atrial septal defect (ASD), patent foramen ovale (PFO), a bicuspid aortic valve respectively, and prominent coronary sinus and persistent left superior vena cava (PLSVC). None of the patients required changes in the preexisting treatment plan, and none were recommended for termination of pregnancy or change in the mode of delivery. Conclusions: Echocardiographic evaluation of asymptomatic antenatal mothers is clinically unjustified. If CVD is diagnosed in asymptomatic mothers, it would primarily belong to the low-risk category and would not contribute to the intrapartum or peripartum care plan in any form but add to the economic burden compromising other essential antenatal care services. [ABSTRACT FROM AUTHOR]