Background: Placental insufficiency is one of the highly prevalent clinical concerns in obstetrics. It is becoming increasingly obvious that its presence significantly affects fetus and placenta, with ramifications on the metabolic, cardiovascular, and neurological development until adulthood.  Purpose: To assess the effect of umbilical cord milking (UCM) on selected maternal and premature neonatal outcomes among women with placental insufficiency. Design: Quasi experimental design. Setting: Obstetrics and Neonatal Intensive Care Units (NICU) in Menoufia University Hospital at Shebin El-Koom. Sampling: A purposive sample of 80 pregnant women diagnosed with placental insufficiency and their premature neonates.a simple random sample was done to assign women into study(G1=40)  and control G2=40) groups. Instruments: For data collection three instruments were used. Characteristics of pregnant women and premature neonates' assessment sheet, maternal health outcomes assessment sheet, and preterm neonates' health outcomes assessment sheet. Results: Premature infants in group I had elevated CD34 (1.13 ± .65 vs .40 ± .20), hematocrit percentage (48.25 ± 5.71vs 40.47 ± 3.37), hemoglobin (Hb) (17.37 ±.95 vs 14.18 ± .78), and peak TSB within 24 h of life than premature neonates in group II. No statistical significant differences were found between studied women in relation to duration of third stage of labor or occurance of postpartum hemorrhage (PPH). Conclusion: Performing UCM for prematures elevated CD34 percentage and Hb levels (at birth and at 2 months) reduced their need for PRBCs transfusion and reduced the duration of oxygen management.  However, it did not influence the length of third stage of labor or maternal PPH. Recommendations:  Further studies related to UCM should be developed to a larger number for pregnant women and neonate in other units assure the generalizability of the research results.