A high incidence of congenital neural tube defects was suspected among the babies born in East Delhi. The hospital data of 30 months was reviewed to find out the incidence and to evaluate the prenatal diagnosis in these disorders. An incidence of 7/1000 births was found to be correct in all cases of anencephaly and hydrocephalus. However, spina bifida and encephalocele were missed in 25% of cases. All patients were diagnosed late during pregnancy mainly because of late booking. Early booking and a high index of suspicion are desirable for early prenatal diagnosis.