Vaginal bleeding during the first trimester has been estimated to occur in 16% of all pregnant women, while the frequency of spontaneous abortion is traditionally estimated as 10-20%. The clinical approach though helpful is of limited value. Despite the latest technological developments and laboratory diagnosis the desired goal of early recognition is not achieved. The objective of the study to evaluate role of ultrasound in patients with first trimester vaginal bleeding. Hospital based study. A total of 100 cases presented with complaint of bleeding per vaginum during first trimester, were enrolled for study. Ultrasonographic examinations were done per abdominally by using ultrasound equipment. The data showed that it is the common problem in 20-30 age pregnant womens. In the present study various types of abortions constituted the commonest cause of first trimester bleeding. All cases the cases were diagnosed correctly on ultrasonography with 100% sensitivity and accuracy and managed appropriately. So ultrasound helped in establishing correct diagnosis timey and decides the line of management.