Objective The study aimed at assessing trans-placental transmission of Chlamydia trachomatis (CT) and fetal survival at birth among CT infected mothers. Study Design This is a non-interventional prospective cohort study. Population /Study Setting The study was conducted among two thousand and fourteen pregnant women attending antenatal clinic at the Cape Coast Teaching Hospital. Methodology Cord blood from neonates born to one hundred and twelve (112) pregnant women whose cervical samples were positive for CT at first ANC visit were screened by Polymerase Chain Reaction (PCR) for CT infection. Transplacental transmission of CT was considered when CT DNA type-specific agreement was observed between the samples of maternal cervical specimen and the corresponding neonatal cord blood. A neonate who did not survive at birth at > 28weeks