Recurrent miscarriage is defined as the loss of three or more consecutive early pregnancies irrespective of the gestation. It occurs in 0.5-2% women. Unexplained miscarriage occurs in about 50% of women attending specialist recurrent clinics. Etiology of recurrent miscarriage can be broadly categorized into genetic, infective, structural, endemic, immune and idiopathic causes. Sonographic findings of recurrent miscarriage depends on the stage of gestation and type of abortion e.g. irregular gestational sac contour, presence or absence of yolk sac or embryo, subchorionic hematoma and retained products of conception and how to differentiate them from blood clot. Prospective study of 50 patients with current pregnancies at 9-12 weeks of gestation was done. The patients were divided into two groups: cases and controls. The cases had history of recurrent miscarriage while the controls had normal obstetric history. They have almost the same inclusion criteria. Those patients underwent 1st trimester transvaginal ultrasonography. The aim of this work is to evaluate efficacy of transvaginal ultrasound (9-12 weeks) in assessment of uterus, fetus and other ultrasonographic parameters in patients with recurrent first trimester miscarriage.