Introduction: : Anaemia in pregnancy, defined by the World Health Organization (WHO) as haemoglobin (Hb) levels <11 g/dL, affects millions of pregnant women worldwide, particularly in developing countries. Anaemia during pregnancy remains a significant global health concern, contributing to maternal and foetal morbidity and mortality. This study aims to evaluate the maternal and foetal outcomes among labouring women with moderate and severe anaemia. Materials and Methods This is a Retrospective and observational study was conducted in the Department of OBGY. Pregnant women presenting in labour at a tertiary care hospital with documented moderate (Hb 7–9.9 g/dL) or severe (Hb <7 g/dL) anaemia. Data were collected from hospital records, including maternal haemoglobin levels, obstetric history, mode of delivery, birth outcomes, and neonatal APGAR scores. The presence of maternal complications such as postpartum haemorrhage (PPH), infections, and the need for blood transfusion were documented. Results The proportion of primiparous women was similar in both groups (54.2% in moderate anaemia vs. 56.3% in severe anaemia), suggesting that parity did not influence the severity of anaemia. Antenatal Care Visits: Women with severe anaemia had slightly fewer antenatal care visits (3.8 ± 1.4) compared to those with moderate anaemia (4.1 ± 1.2), though this difference was not statistically significant (p=0.09). The incidence of PPH was significantly higher in women with severe anaemia (25.0%) compared to moderate anaemia (12.5%, p=0.02). Blood Transfusion: A significantly higher proportion of women with severe anaemia required blood transfusions (62.5% vs. 20.8%, p<0.001), reflecting the critical need for intervention in this group. Conclusion: The results indicate that severe anaemia is associated with increased risks of postpartum haemorrhage, preterm birth, and neonatal intensive care unit (NICU) admission. This study emphasizes the need for improved prenatal screening and timely intervention to mitigate adverse outcomes.