Teenage pregnancy is considered to be an important public health problem and it is most prevalent in sub-Saharan Africa. Studies from developed and developing countries regard-ing adverse teenage pregnancy outcomes differ. The objective of this study is to investigate adverse obstetric outcome in teenage pregnancy in comparison with the adult pregnancy at a tertiary hospital in South Africa. A retrospective comparative study was conducted target-ing the records of pregnant patients who delivered at a tertiary hospital in South Africa from 1st September – 30th November 2010 where the pregnancy outcome of teenagers who were less than 18 years old were compared with the adult women (≥18 years). Binary logistic regression method was carried out to find if teenage age was a significant predictor for the negative pregnancy outcome. Overall, the teenage pregnancy rate over the study period was 10.3%. Significantly higher rate of caesarean delivery was found among adult mothers compared to teenage mothers (p=0.002). Regarding preterm delivery, low birth weight, very low birth weight rate, fresh stillbirth and macerated still birth rates were found to be simi-lar between the teenage and adult mothers (p>0.05). Comparing mean Apgar score between the teenage and adult mothers, the study found significant difference of mean Apgar score at 5 min (9.0 vs. 8.5), (p=0.016).This study highlighted that the teenage mothers show similar obstetrics outcome when compared with their adult counterparts.