Background: In early pregnancy, it is essential to emphasize viability and gestational age precisely. Researchers tried to discover some useful sonographic indicators in early pregnancy so as to expect the outcome of the ongoing pregnancy. The aim of this study is to assess first-trimester ultrasound measurements for the prediction of early pregnancy loss. Method: This is a prospective observational cohort study done in the outpatient clinic of obstetrics and gynecology of El Minia maternity university hospital from 1st February-31st August 2021. A random sample of 143 pregnant women selected, 7 were lost to follow up. For the 136 pregnant women followed 9(6.6%) had early pregnancy loss, and 127(93.4%) continue pregnancy after 12 weeks. Results: 136 pregnant women examined by using transvaginal ultrasonography. The readings at 6th week of gestation for the (GSD, YSD, CRL, and FHR) were (13.05± 1.17), (2.88± 1.62), (2.79± 0.72), & (94.5± 9.54) respectively, lower among those with first trimester loss than those continue pregnancy (28.71± 5.72), (4.29± 0.33), (5.61± 0.55), and (130.9± 3.3). The readings at 12th week of gestation for the (GSD, YSD, CRL, and FHR) were as follows; [(22.59± 3.15), (3.24± 0.27), (11.7± 1.59). & (148.5± 0.9)] were lower among with first trimester loss group than those continue pregnancy [(65.12± 4.51), (4.95± 0.77), (55.77± 6.27) & (188.1± 5.5)]. Conclusions: The current study found that lower Gestational Sac Diameter, Youlk Sac Diameter, Crown–Rump Length, and Fetal Heart Rate may indicate early pregnancy loss.