Objective: To study obstetrics and perinatal outcome in nulliparous teenage singleton pregnancies at a referral teaching hospital in the eastern province of Saudi Arabia. Method: All singleton births during 1996–2000 of nulliparous mothers aged ≤17 years at King Fahd University Hospital were reviewed (n = 102) and compared with births of a control group of nulliparous mothers aged 20–24 years who delivered during the same period (n = 102). Results: The incidence of nulliparous teenage pregnancies was 0.8%. As compared with women aged 20–24 years, women of 17 years or less were at higher risk of very preterm birth (p < 0.05). The 5-min Apgar scores were not different between the two groups. Babies born to younger mothers had a significantly lower birth weight than those born to older mothers (p < 0.001); the incidence of a low birth weight (<2,500 g) was significantly lower in the control group (p < 0.04). There were no significant differences in distribution of mode of delivery, admission to the special care baby unit, antenatal complications, cesarean section indications, perinatal mortality rate, and early neonatal complications between the two groups. Conclusion: The increase in the very preterm births and the subsequently lower birth weight observed in nulliparous teenage women suggest that the maternal age may be a risk factor for very preterm births and associated long-term hazards.