Background: One of the most common conditions affecting women's health throughout the childbearing years is bacterial vaginosis (BV), which have a negative impact on pregnancy. Nutraceutical proteins and probiotics (such as lactoferrin) can help restore the equilibrium of the vaginal microbiome, which can be of significant use in avoiding unfavorable pregnancy outcomes. Aim of Study: This study aimed to evaluate the efficacy of lactoferrin in prevention of recurrent bacterial vaginosis in third trimester singleton pregnancy. Patients and method: This was randomized controlled clinical trial conducted at Obstetrics and Gynecology Department, Zagazig University, Outpatient Clinic. The study included 66 cases with history of receurent bacterial vaginosis divided into two groups: Study group that received lactoferrin  oral consumption of 2 capsules/day for 5 days, then 10 consecutive days at the dosage of 1 capsule/day (pravotinR). Control group, which did not receive lactoferrin. All of the ladies took 1 capsule of lactoferrin or a placebo daily for 10 days straight each month during the follow-up period. Results: There was significant differences in microbiological cure rate as detected by Nugent scores in studied  groups at T1 and T2 where the study group had microbiological cure rate than control one (57.6% and 9.1%) versus (72.7% and 18%) respectively. Low APGAR1, preterm, CS delivery type, LBW and PROM were significantly higher with control group. Conclusion: Repeated sessions of orally delivered probiotics in conjunction with lactoferrin are beneficial in preventing BV recurrences, as evidenced by much greater clinical and microbiological cure rates, as well as a favourable safety profile.