Aim: assessment of the Cord Serum Albumin level (CSA) and predicting neonatal hyperbilirubinemia based on cord serum albumin levels. Material and methods: This prospective observational study was carried out in the Department of Obstetrics and Gynecology, Anugrah Narayan Magadh Medical College and Hospital Gaya, Bihar, India for 16 months. Total 120 simultaneously born full term healthy neonates were included in this study. 3 ml of cord blood was collected at birth in a SST and was sent for estimation of cord blood albumin and TSH. On detecting the presence of icterus, Blood was sent for estimation of Total Bilirubin (TB). Results: In the study a total of 120 babies were registered. Out of this 65 (54.17)% were female and 55 (45.83%) were male. There was no significant difference in the number of male and female babies. Depending on the cord albumin levels the babies were grouped into two: >2.8 gm/dl (Group 1) and <2.8 gm/dl (Group 2). Lower normal limit for cord serum albumin in term babies is 2.8g m/dl. There was a total of 95 babies in Group 1 and 25 babies in Group 2. The mean gestational age was among Group 1 was 39.22±1.17 weeks and Group 2 was 38.37±2.51. It was noted that babies born at a lower gestational age had a higher chance of having a low albumin value and subsequent hyperbilirubinemia (p=0.001). A significant correlation was noted between the Cord TSH and cord Albumin levels in this study. Out of 120 babies, 56 babies developed icterus. Under group 1, 37 babies developed icterus and under group 2, 19 babies developed icterus. The total bilirubin levels were significant in Group 2 (p<0.001). 26 babies of the 56 with icterus required phototherapy and it was noted that majority of these babies were from group 2 (p<0.05). In our study, the sensitivity of cord albumin to detect hyperbilirubinemia in newborn was determined and found to be 76%, while specificity was 66%. The positive predictive value was found to be 40% and the negative predictive value was found to be 89%. Conclusion: Cord albumin levels help to determine and predict the possibility of hyperbilirubinemia among neonates. Hence this can help to identify the at-risk neonates. So, routine determination of cord albumin can be advocated to keep a track on at risk neonates.