Background: recurrent pregnancy loss (RPL) is defined as at least two or three sequential abortions before the 20th week of gestation. RPL occurs in 1% to 5% of all pregnancies. Aim of the Work: to assess the efficacy of low dose aspirin and steroids therapy versus Aspirin Study in the management of women with recurrent miscarriage. Patients and Methods: this randomized clinical trial was conducted in the repeated miscarriage clinics in the Obstetrics and Gynecology Department, in Al-Azhar University Hospital on 100 pregnant women, who fulfilled the inclusion criteria and after taking an informed consent. Group 1: included 50 pregnant females administered with low dose aspirin 75 mg tablet (one tablet twice daily) and prednisolone 5mg two tablets twice daily (20mg). Group 2: included 50 pregnant females administered with low dose aspirin 75 mg tablet (one tablet twice daily). Both groups were followed in Elhussein hospital recurrent miscarriage clinic every two weeks by ultrasonography from the incidence of the pregnancy till delivery. Results: women treated with prednisolone (PSL) plus LDA had a 32.2% higher live birth rate than group II and according to on-going pregnancy data was in group I 37/50(74%) and in group II 21/50(42%) OR (C.I. 95% 4.128 [2.142-7.952] RR (C.I. 95%1.875 [1.401-2.505] p<0.001, with a significant difference between the two groups. There was a significant difference between the two groups as regards the development of bruising (P<0.05). Conclusion: combination treatment consisting of prednislone and low dose aspirin might be an effective treatment for women with idiopathic pregnancy loss.