Background: First trimester vaginal bleeding is the occurrence of bleeding during first 12 weeks of gestation. One of the most common complications seen during in first trimester, with incidence of 20% of clinically recognised pregnancies. Vaginal bleeding can be a normal sign of implantation of pregnancy. Approximately 15% to 20% of clinically recognized pregnancies miscarry. First trimester bleeding may predict higher risk for preterm birth, intrauterine growth restriction, preterm premature rupture of membranes, and placental abruption, Intrauterine growth restriction(IUGR), Low Birth Weight(LBW). So it is necessary to evaluate the first trimester vaginal bleeding in pregnant women, due to increased risk of later pregnancy complications. These risk factors should be considered when deciding on antenatal surveillance and management of such pregnancies. Aim of study: To assess the pregnancy outcome in women presenting with first trimester vaginal bleeding. Objectives 1. To assess the maternal outcome in terms of Spontaneous Abortion, Preterm labour, PPROM, PROM, Preeclampsia, APH and Mode of delivery. 2. To assess foetal outcome in terms of preterm, IUGR, LBW, and IUFD. Methods: This prospective cohort study was conducted on 100 women coming with 1st trimester vaginal bleeding to OPD / emergency during the period December 2016 to June 2018 fulfilling the inclusion criteria in ESIC PGIMSR Hospital, Rajajinagar, Bengaluru. A written informed consent taken after explaining the procedure, and are followed throughout the pregnancy. In such patient’s pregnancy outcomes like maternal-spontaneous abortion, preterm delivery, premature rupture of membranes, preeclampsia, APH mode of delivery and foetal outcomes-in terms of, intrauterine growth restriction, low birth weight, intrauterine foetal demise studied. Out of 100 women 31 (31%) ended in abortion and 69 (69%) continued the pregnancy. Among those who continued the pregnancy no complication were seen in 21(30.43%) cases, Preterm in 16(23.18%) cases, PPROM seen in 7(10.14%), PROM in 10(14.49%), PIH in 8(11.60%), placenta previa 5(7.24%), severe PIH +Abruptio placenta 2(2.90%) of cases. Foetal outcome seen are in 26(37.68%) cases no complications, preterm in 23 (33.34%) cases, IUGR in 10 (14.50%) cases, LBW in 7(10.14%) cases, IUFD in 3 (4.34%) cases. Conclusion: From the above study we concluded that women with first trimester vaginal bleeding are at increased risk of later pregnancy complications. So precise management and planning will reduce the poor maternal and foetal outcome.