Background: Second trimester short cervical length identifies women at increased risk for an early spontaneous Preterm birth (sPTB), hence raising a compelling needed for Cervical Assessment for prediction and possible Preventing Preterm Delivery. Objective of the study: to assess the implications associated with a short cervical length as well as the use of ultrasonographic-derived cervical length measurement in predicting preterm birth. Methods: the present review includes relevant randomized controlled trials (RCTs) that investigated the in Medline (via PubMed), Cochrane Library and Embase. Retrospective and Prospective Cohort studies, Case-control and Randomised controlled trials. There were no restrictions by outcomes examined, language or publication status. Results: The critical search results yielded 6 articles (randomized trials=2, cohort studies=3, case-control study=1) representing 653 patients . Five of the 6 presented similar pregnancy outcomes (spontaneous preterm birth or pregnancy loss < 24 weeks' gestation) between the ultrasound-indicated and the history-indicated cerclage groups.  45–69% of the patients followed with cervical ultrasound were able to avoid cerclage.  Conclusion: Evidence from randomized trials supports that transvaginal ultrasound is predictive of preterm birth in women with prior preterm birth and a short cervix. The thresholds proposed vary from 15 mm to 28 mm and cerclage is thus recommended.