Introduction: Congenital anomalies, a leading cause of infant morbidity and mortality, are vital areas of study in prenatal medicine to explore the relationship between congenital anomalies and birth order among antenatal mothers. Methods: This retrospective follow-up study was conducted in a first referral hospital in Bangalore, India between July 2021 and June 2022. Data from 1,432 antenatal mothers were analyzed, focusing on socio-demographic characteristics, congenital anomalies, and birth order. Congenital anomalies were diagnosed based on established medical criteria through detailed examination of antenatal scans and medical records. Descriptive statistics with Odds ratio with 95% CI were employed to assess associations between variables. Results: The study showed variations in the incidence of congenital anomalies with birth order, with first-borns presenting the highest incidence at 42.8%. Anomalies were predominantly observed in the maternal age group of 22__ampersandsignndash;25 years (50%) and in non-consanguineous pregnancies (81%). Renal anomalies were the most prevalent, constituting 59.5% of the total anomalies. Conclusion: The variations observed in anomaly incidences based on birth order emphasize the need for further research in this area and the development of targeted preventive strategies and interventions to mitigate the risk of congenital anomalies in different birth orders.