Background: Meconium characterized by being sticky dark-green in nature composed of gastrointestinal secretions besides various cellular debris and amniotic fluid that accumulate within the fetal gastro intestinal system that reflect the maturation of fetal gastrointestinal activity. Aim: to investigate obstetric clinical outcomes in meconium stained amniotic fluid cases comparing between thin and thick meconium. Methodology: A clinical research case-control trial investigating meconium stained amniotic fluid, with clinical value as regards early maternal and neonatal wellbeing aspects conducted by recruitment 200 research study subjects having meconium stained amniotic fluid with additional 100 research study subjects having clear amniotic fluid as research control group. Results: There was no statistically significant difference between both research groups as regards O2 supplementation endotracheal intubation, ventilator support, antibiotics, inotropes, screen positive, culture positive (p values =0.077, 0.580, 0.841, 0.390, 0.277, 0.157,0.391 consecutively). Whereas neonatal death was statistically significantly higher among meconium stained cases research group (p value=0.032). Thick meconium was associated with more abnormal fetal heart rate pattern in a statistically significant manner (p value<0.001). Conclusions: This research study revealed the critical importance of meconium heavy staining of amniotic fluid to abnormal fetal heart rate denoting that it could be implemented as clinical predictability tool for fetal distress even in absence of fetal monitoring, however future research efforts are required to be multicentric in fashion with larger sample sizes to verify our study results.