Background: the proportion of women having their first delivery at “advanced maternal age” is on the increase due to delayed child bearing among some woman in pursuit of education and carrier. Maternal age at first pregnancy is a determinant factor that could affect pregnancy outcome. Woman aged 35years and above undergoing their first pregnancy are often considered to be at increased risk of adverse maternal and perinatal outcomes compared to their younger counterparts. Objectives: To determine the prevalence of elderly primigravidae and compare their pregnancy outcome with their younger counterparts at the Usman Dan Fodio University Teaching Hospital, Sokoto (UDUTHS) Nigeria. Materials And Methods: These was a retrospective case control study comparing the pregnancy outcome of primigravid mothers aged 35years and above with those of younger pregnant women aged less than 35years who delivered at UDUTHS between January 2017 to December 2021. Results: There were 9622 deliveries during the period under review, out of which 236 were primigravidae. Elderly primigravidae constituted 9.3% (n=22) while the younger ones were 90.7 % (n=214). The prevalence of elderly primigravidae was 0.2%. The elderly primigravidae were more prone to pre-eclampsia and ante partum haemorrhage compared to younger primigravidae. There was statistically significant higher caesarean section rate (x2=15.1, P value =0.02) among the elderly primigravidae compared to the younger counterparts. There was no significant differences in the other maternal and fetal outcome. Conclusion: The prevalence of elderly primigravidae in this study was 0.2%. They were at increased risk of pre-eclampsia and caesarean deliveries than their younger counterparts. However, there was no significant difference in the fetal outcome among the study groups.