Introduction: One third of first trimester bleedings happen in pregnancies that are otherwise normal. Nearly 50% of pregnancies end in pregnancy loss, if pregnancy continues, poor maternal and fetal outcomes such as preterm delivery, Preterm preLabor rupture of membranes, preeclampsia, placental abruption and intrauterine growth restriction occur. Aims: To know the obstetric outcome of pregnancy complicated by first trimester vaginal bleeding. Materials and Methods: Prospective study where All pregnant women reporting to Government Maternity Hospital, Hanmakonda with first trimester vaginal bleeding were included. Minimum 100 participants meeting inclusion criteria from January 2018 to July 2019 were there. Results: 62% of early vaginal bleeding had pregnancy loss (miscarriage). Only 37% had threatened abortion where pregnancy continued. Recurrent vaginal bleeding had higher risk of pregnancy loss than single episode of bleeding PV, of which most of them had inevitable abortion. Most of the cases of threatened abortion were induced (38%), mainly for PROM, IUGR and prolonged pregnancy. Other indications were PPROM, gestational hypertension, GDM. Only 22% had spontaneous onset of Labor. Cesarean section rate was not significantly high (22%) and main indication was post LSCS status, malpresentation, NPOL followed by APH and fetal distress. Conclusion: To conclude, adverse maternal and fetal outcome predicted following threatened miscarriage should be taken into consideration when deciding upon antenatal surveillance. The identification of these high risk groups should enable better management protocols to improve neonatal outcome.