BACKGROUND: Recurrent spontaneous miscarriages (RSM) remain a major challenge to gynaecologists as 50% of aetiologies of spontaneous miscarriages are unknown. Insulin resistance (IR) has been implicated as an aetiological factor. However, there are insufficient and conflicting evidence regarding the contribution of insulin resistance to the occurrence of RSM. OBJECTIVE: To investigate the relationship between insulin resistance and first trimester recurrent spontaneous miscarriages in comparison with first trimester normal pregnancies. DESIGN: Case control study. METHODOLOGY: This was a case-control study involving 80 women with first trimester RSM (cases) and 80 Women with normal first trimester pregnancies with at least one successful pregnancy and no history of miscarriages (Controls). From each participant fasting blood glucose (FG) was assayed by automated colorimetric enzymatic analysis and fasting insulin (FI) was assayed by BIOS Human insulin ELISA kits. Data was analysed using SPSS version 22.0.