Hemolytic disease of the newborn secondary to rhesus alloimmunization was once a major contributor to perinatal morbidity and mortality. Today, rhesus immune globulin has markedly decreased the prevalence of this disease. Failure of rhesus immuno-prophylaxis however still occurs as a result of inadequate use of rhesus immune prophylaxis after potential sensitizing events and administration of inadequate dose. The clinician must be alert to detect rhesus alloimmunization because it still causes significant portion of perinatal mortality. Rhesus disease will have a favorable outcome in most instances if properly managed. The rarity of this condition warrants consideration of consultation or referral to a maternal-fetal medicine specialist. The reduction in perinatal deaths due to hemolytic disease of the fetus and newborn has also occurred as result of the great advances made in neonatal care and in the management of the affected fetus. The Rhesus type is a screening test to determine if the patient is at risk for immunization. Evaluation for the presence of maternal anti-D antibody should be undertaken at the first prenatal visit by performing Indirect Coombs Test. Once sensitization occurs, rhesus immune globulin is no longer effective. Absout 5% of the Indian population is Rh(D) negative.