Objective The aim of this study was to compare pregnancy outcomes in euthyroid women who were anti-TPO Ab ? with those who were anti-TPO Ab -. Design This observational study comprised 1,000 women in the age group of 25-35 years, having normal thyroid function tests, normotensive, non-diabetic, singleton pregnancy and attending Gyn. OPD/ANC up to 20 weeks' gestation and those who were already in the process of abortion. anti-TPO Ab levels of[50 IU/ml were considered as anti-TPO Ab ? . Setting This study was conducted in the SMS Medical College's attached hospital, Jaipur from April 2012 to September 2013. Main Outcome The estimation of the proportion of anti-TPO Abs in the hospital-based population and the comparison of pregnancy and neonatal outcomes in anti-TPO Ab ? and Ab -euthyroid women were done. Results The main result showed increased rates in miscarriages (13.33 vs. 2.34 %, P \ 0.001), LBWs (25 vs. 5.12 %, P \ 0.001), preterm deliveries [\34 weeks] (5 vs. 1.80 %, P [ 0.05) in anti-TPO Ab ? women. Conclusions The current study revealed that anti-TPO Abs are strongly associated with miscarriage and LBW irrespective of their gestational age. However, we did not find any correlation with the other complication as found in the studies by Abbassi-Ghanavati, Negro et al.