Babies who have suffered hypoxial events in Nigeria are commonly assessed using Apgar scoring. This method of assessment is however not objective, as lowering of scores can be due to conditions other than asphyxial events such as prematurity, congenital anomalies, and use of sedatives in the mother. Lowering of blood pH is one of the most defining biochemical consequences of hypoxial events. Blood pH measurement has been recommended by the British and American Colleges of Obstetricians and Gynecologists for all high-risk pregnancies. A combination of indices such as Apgar score, cord blood pH, neonatal neurologic sequelae has been recommended as most effective for early diagnosis of babies who have suffered asphyxia. Unfortunately, not many facilities in developing economies have the capacity to measure cord blood pH. Thus a need for a more readily available index that could serve as surrogate for pH such as nucleated red blood cells. This study was conducted to determine the relationship between fifth minute Apgar score, umbilical cord blood pH and nucleated red blood cell count in term newborns in Lagos, Nigeria. The study was a comparative study conducted from May 2018 to March 2019. A total of 126 neonates, 63 depressed (Apgar score <7 at 5 minutes) and 63 non-depressed (Apgar score ≥ 7 at 5 minutes), who served as controls, were studied. A pretested questionnaire was administered; general examination for pallor, cyanosis, and weight was done at birth. Heart rate, respiratory rate and neurological status within the first 24 hours were noted. Cord blood samples for pH were taken at birth and peripheral venous samples were taken at 6-8 hours of life for the estimation of nucleated red blood cells and white blood cell counts.