<p> Introduction:Meconium Ileus (MI) is one of the causes of intestinal obstruction. Meconium obstruction poses a great challenge not only in recognition and diagnosis but also in the management. Cystic öbrosis has been associated with MI, with the incidence ranging from 15–40%. Aim: To evaluate the clinical presentation, diagnosis, surgical management, postoperative care, and outcome in neonates with meconium ileus. Materials and Methods: This study was done retrospectively in the department of Pediatric surgery and Pediatric, PGIMS Rohtak to include all patients who presented with meconium ileus in pediatric surgery department over a period of 15 years i.e. from 2000 to 2015. Neonatal birth characteristics, surgical öndings, postnatal management and outcomes were reviewed from the data collected from department records. Results: From 2000 to 2015, 30 neonates were managed for meconium ileus. Simple, uncomplicated meconium ileus occurred in 12 infants (40%) and complicated meconium ileus occurred in 18 (60%). Thirty neonates presented with complications of MI including ileal atresia type III in 17, adhesions in 10, and giant pseudomeconium cyst in 10, volvulus in 3 and duplication cyst in 1.Ileal atresia was the commonest complication (41.46%). Conclusion: Early recognition in antenatal period and early surgical management along with good NICU care will help in reducing the postoperative morbidity and mortality.</p>