Study objective: to evaluate the impact of adolescent first and second pregnancy on fetal and maternal outcomes and to assess the prevalence of obstetric complications among this age group. Design: This is a retrospective hospital-based study, women who attended our hospital for antenatal care between January 2014 and January 2015 were considered for eligibility. Adolescents 20 years old who were presented by their first or second pregnancy were included as a study group and were controlled by women between 20 and 35 years old. Statistical analysis was conducted using SPSS software version 22. Setting: Al-Sabeen hospital in Sanaa city (capital of Yemen). Participants: One thousand and two hundred mothers aged less than 20 years (study group) and 2400 control mother whom age ranged between 20 to 35 years (control group). Interventions and Main Outcome Measures: included women were evaluated for the pregnancy, mode of delivery, obstetric adequacy of antenatal care, complications of complications and fetal outcomes. Results: Among the study group, the prevalence of adequate antenatal care visits was higher than the control group (55% vs. 42.5%, P=0.001). Pre-eclampsia was reported in 10% of adolescents versus 5.8% in control group (p=0.001). No gestational diabetes was diagnosed among adolescents. Antepartum hemorrhage was less prevalent among study group (5%) in comparison to the control group (10.8%). Normal vaginal delivery was less while instrumental delivery and Cesarean section rates were more in adolescent group (35% vs. 60%, 45% vs. 25%, 20% vs. 15%, respectively, p=0.05). The rates of intrauterine fetal death (IUFD) and stillbirth were comparable. Women in the control group tended to deliver newborns weighing > 3.5 kg (15% vs. 7.5%, p=0.001). Conclusion: Adolescent pregnancy is a risk factor for pre-eclampsia, anemia, instrumental vaginal delivery and cesarean section. More frequent antenatal care visits may be warranted in these women.