Background: Group B streptococcus (GBS) is a gram positive coccus that colonises the genital tract of about 10-40% of pregnant women. It is implicated in neonatal sepsis in about 1% to 2% of cases without intervention, out of which 10% will have sequelae like meningitis, pneumonia, septicaemia and multi-organ failure. Diagnosis of GBS is made by lower genital tract swab for microscopy, culture and sensitivity. Other organisms may suppress the growth of GBS when the universal culture media is used, hence the need for GBS selective media. There is also varying antibiotics sensitive pattern. Therefore, prophylactic antibiotics in labour to high risk pregnant women should be based on local antibiotics sensitivity. Aim: The study assessed maternal genital tract colonisation by Group B streptococcus and pregnancy outcomes at the Alex Ekwueme Federal University Teaching Hospital Abakaliki. Methods: The study was a prospective cohort study on consenting pregnant women that received antenatal care at AEFUTHA from 35 to 37 weeks gestation. Vaginal swabs were collected in early stage of labour to determine the GBS colonisation and pregnancy outcomes subsequently documented. Analysis was done using frequency tables and percentages for categorical variables, means and standard deviations for continuous variables while comparisons for categorical variables was done using chi-square and t-test for comparison of means.