Preterm births are common. A substantial maternal morbidity accompanies preterm delivery as well as the morbidity associated with prolonged neonatal intensive care. Long-term neurological problems are more difficult to evaluate. Apart from the human cost, the financial cost of providing inpatient care for preterm babies and providing support in cases of lifelong handicap is great. Despite the fact that researchers have evaluated asymptomatic cervical changes that may presage and thus predict preterm labor, and also the knowledge that choriodecidual disruption (releasing phIGFBP-1 amongst other markers) occurs prior to preterm delivery, there is still no standard protocol on the prediction of preterm delivery. In addition, no similar study using phosphorylated insulin-like growth factor binding protein-1 (phIGFBP-1) and cervical length has been done in Nigeria as predictors of preterm delivery. In fact, worldwide, only ten peerreviewed publications spanning a decade, have reported results of observational studies on phIGFBP-1. AIM This study therefore aims at determining whether phIGFBP-1 and transvaginal cervical length assessment, alone or in combination, are useful in the prediction of preterm delivery in our environment. SUBJECTS AND METHODS The study was an analytical prospective cohort study to be conducted at the antenatal clinic, obstetrics and labour wards of Ahmadu Bello University Teaching Hospital, Zaria where consecutive asymptomatic antenatal clients at risk for preterm delivery were recruited from 22weeks gestation, their sociodemographic characteristics and reproductive profile obtained and the cervical length estimation done using transvaginal ultrasound. At 30weeks gestation, phosphorylated insulin-like growth factor-binding protein-1 (phIGFBP1) was assessed from cervical secretions using the Actim Partus bedside test kit and all information entered into a proforma. Patients were followed up till delivery and gestational age at delivery noted. The ability of the tests, singly and in combination, to correctly predict preterm delivery in asymptomatic susceptible patients was determined statistically.