Serum total and ionised calcium levels were measured at birth and at 48 hours in 25 term neonates with birth asphyxia (one minute APGAR score of 6 or less) and in 25 normal term neonates (one minute APGAR score of 7 or more). Infants were categorised into two groups TAGA (term appropriate for gestational age) and TSGA (term small for gestational age). Asphyxiated infants had significantly lower serum total and ionised calcium values at birth as well as at 48 hours. Abnormal clinical features were observed in 48% of asphyxiated infants. Low ionised calcium was detected in symptomatic babies, who had otherwise normal total calcium values. Due to hyocalcemia especially ionised calcium in asphyxiated infants and high frequency of functional derangement associated with this hypocalcemioa, serial monitoring of serum isonised calcium levels is necessary.