Background. Autism spectrum disorder (ASD) is primarily considered as psychiatric disorder but physical features are associated with it. Motor impairments are manifested as both delays and deficits, with delays found in gross motor, fine motor and speech domains and deficits found in praxis, coordination and gait. Gross motor functions develop overtime but fine motor is still found to be delayed even at the age of three years. Hand Grip Strength (HGS) is reduced in ASD which might be one of the factors for dependent functional fine motor task. The extent of muscle weakness and its impact on fine motor skills (FMS) is not clear which would provide an insight into the child’s physical limitations and plan of care. Aim. The aim of the study was to find the extent of muscle weakness in hand and impact of hand grip strength on fine motor skills in ASD children. Materials and Methods. This cross sectional study was carried out in 65 ASD children who met the inclusion criteria. Subjects were recruited from Vidyasudha – Centre for children with special needs. Children diagnosed as ASD with Childhood Autism Rating Scale were included in the study. Level of the FMS was assessed by Peabody Developmental Motor Scale (PDMS-2) and grip strength was quantified with Martin Vigorimeter. Results. Unpaired t test analysis showed statistically significant change of HGS between normative values of Martin Vigorimeter in Indian population and ASD children with p < 0.05. Pearson’s correlation showed strong positive correlation between fine motor skills and hand grip strength with r value of > 0.7 and p ≤ 0.05. Conclusion. The result concludes that there is significant weakness in hand grip strength with positive correlation of fine motor skills in ASD children. The result insists routine assessment of muscle strength and use of Martin Vigorimeter for assessing hand grip strength in ASD children followed by strengthening exercises to improve activities of daily living and attain functional independency.