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Introduction: Birth asphyxia is a disturbance to the fetus or newborn due to failure to breath or breathing poorly, leads to decrease oxygen perfusion to various organs. Many neonatal deaths occurred each year due to birth asphyxia. Objective: The objective of this study was to determine the risk factor associated with birth asphyxia. Methods: This Case-Control study was conducted at department of Obstetrics and Gynecology Sir Gangaram Hospital, Lahore. The study was completed in 9 months after approval of synopsis. A total of 154 cases and 154 controls were taken in this study. All new born baby (age < 2 days), having any mod of delivery (vaginal or cesarean section (C-section) and baby born at gestational age (28-41weeks) were included. New born with any anomaly, mother with previous history of birth asphyxia and twins were excluded from study. After taking consent form, data collection divides into three factor sections i.e.: maternal, intrapartum and neonatal sections. After taking consent form, data collection divides into three factor sections i.e.: maternal, intrapartum and neonatal sections. Data was entered and analyzed by SPSS version 24.0 Mean + SD was calculated for quantitative data. Frequency and percentage was calculated for categorical data. Chi-square test was applied for categorical data. Independent sample T-test/Mann Whitney u test was applied. Odds ratio also be calculated. Logistic Regression was applied to confirm possible risk factors. P value = 0.05 was considered as significant. Results: The mean age of mothers in cases was 29.66 ± 5.20 years and in control groups was 25.29 ± 3.95 years, the mean of mothers was statistically higher in cases than controls, p-value <0.001. The mean gestational age of mothers in cases was 37.34 ± 1.37 weeks and in controls was 38.01 ± 0.91 weeks respectively, the mean gestational age was statistically lower in cases as compared to control, p-value < 0.001. It is concluded that the risk factors for birth asphyxia are found as Father's education (AOR = 4.59), Oligohydramnios (AOR = 5.29), Preterm (AOR = 4.24), Gravida (AOR = 3.33), Breech position (AOR = 3.13), gestational diabetes mellitus (AOR = 3.11), ANC (AOR = 2.71), pregnancy induced Hypertension (AOR = 2.61), and maternal age (AOR = 1.28). Conclusion: It is concluded that there are many factors associated with birth asphyxia that can be managed during pregnancy or immediately before delivery. By controlling such factors, risk of birth asphyxia can be controlled, by reducing birth asphyxia we can reduce neonatal mortality. [ABSTRACT FROM AUTHOR]