Introduction: One key aspect of fetal assessment is the measurement of amniotic fluid volume (AFV) which has been linked to various pregnancy complications. Postdated pregnancies those extending beyond 40 weeks of gestation present significant risks such as fetal distress, oligohydramnios, meconium staining, macrosomia and fetal post-maturity syndrome. Management of these pregnancies varies with some advocating expectant monitoring while others recommend induction of labor to mitigate risks. Ultrasound assessments like the amniotic fluid index (AFI) are crucial in guiding decisions about timing and mode of delivery, balancing the risks of prolonged pregnancy with those of premature birth. The aim of this study was to evaluate the AFI in postdated pregnancies and assess the associated maternal and fetal outcomes at Pravara Rural Hospital (PRH), Loni. Materials and Methods: This descriptive cross-sectional study was conducted at PRH, Loni with a sample size of 220 postdated pregnant women over two years. The inclusion criteria were women aged 18-35 years with a single live intrauterine gestation, cephalic presentation, and gestational age >40 weeks, who provided informed consent. The women underwent history-taking, obstetric examination and investigations including ultrasound and fetal Doppler. Delivery outcomes, including Apgar scores, birth weight, NICU admissions, and perinatal follow-up were recorded. Results: Among 220 participants, 92.72% were under 20 years old, with a mean age of 19.49 ± 1.44 years. Meconium-stained liquor occurred in 55.91% of cases. Most deliveries were vaginal (79.55%), followed by LSCS (16.36%). The mean birth weight was 3.03 ± 0.37 kg with 50.45% of infants having an Apgar <7. Maternal complications included atonic PPH (2.73%) and perineal tear (2.27%). Fetal complications included meconium aspiration syndrome (4.09%) and perinatal mortality (4.09%). Conclusion: Postdated pregnancies carry significant risks. Early assessment and