Background: Exchange transfusion (ET) is required in hyperbilirubinemic hospitalized neonates. Aim & Objective: To determine the mother’s ABO blood group wise changes in hematological and biochemical parameters before and after exchange transfusion in neonates. Materials & Methods: The study center at SMS and associated hospitals. The blood bank was licensed and fully equipped. Fall in serum bilirubin minimum 40 cases was required as the sample size of the present study. Results: The distribution of blood groups among 40 neonates revealed B Rh +ve in 19 (47.5 %) neonates, B Rh− ve in 02(5%), neonates, O Rh+ ve in 6 (15%) neonates, O Rh− ve in 01(2.5%) neonates, A Rh+ ve in 10(25%) neonates, A Rh− ve in 0 (0%) neonates, AB Rh+ ve in02 (5%) neonates and AB Rh− ve in 0 (0%) neonates and The distribution of blood groups among the 40 Mother’s was B Rh + ve in 06 (15%), B Rh –ve in06 (15%), O Rh + ve in 16 (40%), O Rh –ve in04 (10%), A Rh + ve in 0 (%), A Rh –ve in 06 (15%), AB Rh + ve in 0 (%) and AB Rh – ve in 02 (5%) mother’s respectively.