Vaginal bleeding complicates a percentage of all pregnancies. Previous study has connected vaginal bleeding to a twofold increase in risk, with the risk being higher in some, but not all, studies for heavy, recurrent, and late pregnancy bleeding. In both the first and second pregnancies, intrauterine growth restriction (IUGR) is a significant cause of perinatal morbidity and mortality. The goal of this study is to investigate the link between vaginal bleeding and IUGR. This prospective cohort study included 68 case of pregnant female with first trimester vaginal bleeding at Obstetrics& Gynecology Department, Faculty of Medicine, Zagazig University. The duration of the study was from February 2021 to December 2021. At the end of the study 56 cases completed the study. Clinical examination revealed that the fundal height of the uterus was at least 4 weeks lower than the expected height based on gestational age. Vaginal haemorrhage was classified as minor when the lady did not need hospitalisation and significant when she did. There were correlations discovered between vaginal bleeding and delivery outcomes, notably IUGE. There was significant decrease in birth weight and Apgar score with increase severity of vaginal bleeding. There was significant increase in NICU admission and IUGR occurrence with increase severity of vaginal bleeding. There was a significant positive relationship between vaginal haemorrhage, IUGR, and NICU hospitalisation. Vaginal haemorrhage, birth weight, and APGAR score all had a significant adverse connection. There was significant association between vaginal bleeding and IUGR occurrence. There was no significant difference between mild and moderate or moderate and severe vaginal bleeding. First trimester vaginal bleeding is significantly associated with IUGR occurrence and other pregnancy adverse outcomes. Also IUGR occurrence and other pregnancy adverse outcomes prevalence increase with increase severity of bleeding. We found no difference in IUGR occurrence in mild versus moderate or moderate versus severe vaginal bleeding.