ABSTRACT Background: to assess the possibility of hazard in early pregnancy, the first trimester 3D ultrasound can be used. Objective: to evaluate the role of 3D ultrasound measurements of yolk sac volume (YSV), gestational sac volume (GSV) and retrochorionic blood flow in predicting possibility risks in pregnancy during the first trimester. Methodology: This prospective cohort study carried out at Al-Zahraa Hospital included 100 pregnant women aged (20-35 years) at (5-11 weeks) of conception attend the outpatient obstetric clinics for antenatal care during a study period of one year (Dec.2018 and Dec.2019). They were selected by convenient sample and divided into; repeated pregnancy failure group (50) patients and normal control group (50) persons with the same criteria. Patients included in the study were offered 3D ultrasound and afterwards they were followed up till twenty weeks to predict pregnancy result. Results: The ROC curve was used to identify the area under the curve for retrochorionic arteries (RI) sensitivity was (84.0%); for gestational sac volume (77.0%); for yolk sac volume (71.0%) and for crown rump length (52.0%). Conclusion: First trimester 3D ultrasound assessments of GSV, YSV and retrochorionic blood flow give an accurate method for predicting outcome of pregnancy.