Background: To determine the clinical value of first trimester and second-trimester uterine artery Doppler indices in the prediction of adverse pregnancy outcome (preeclampsia, IUGR, unexplained stillbirths). Materials &Methods:This was a prospective study in which uterine artery Doppler was performed at 22-24 weeks of gestation 100 high-risk women attending antenatal OPD at Dr psims & rf in the first trimester between 11 to 13 weeks6days POG for early pregnancy scan and uterine artery Doppler, followed with second-trimester uterine artery doppler at the time of anomaly scan 18 to 20weeks from June 2019 to June 2020. Results: Among the high-risk women in the present study the risk factors are chronic hypertension (40%), precious pregnancy (10%), overt DM (12%), previous history of preeclampsia (15%),RPL(10%),SLE (7%), twins (3%), oligohydramnios (3%). Abnormal uterine artery Doppler indices had the highest sensitivity (100.0%) for predicting preeclampsia in the mother and the lowest sensitivity (51.4%) for predicting preterm. For predicting pre-eclampsia, IUGR, neonatal mortality, preterm the sensitivity of RI was 100%,85.7%,83.3%,51.4% respectively, and the specificity was 92.3%,100%,95.8%,100% respectively. Overall, 35 (35.0%) women had a preterm delivery, 16 (36%) had a cesarean delivery, and 19 (61%) had a spontaneous vaginal delivery. Among the preterms, 18(51.4%) died due to prematurity and its associated complications. The positive predictive value of abnormal uterine artery Doppler was highest for preeclampsia (36.84%) among all adverse pregnancy outcomes assessed. Conclusion: Uterine artery Doppler ultrasonography at 22-24 weeks of gestation is a significant predictor of at least one adverse pregnancy outcome, with the highest prediction for preeclampsia.