Background: Teenage pregnancy is a high risk pregnancy associated with obstetric, fetal, neonatal and psycho‑social complications. These complications are worsened by poverty, ignorance and lack of special care during pregnancy. Aim: The objective of the following study is to determine the obstetric and neonatal outcome of teenage pregnancy. Materials and Methods: A retrospective case control study was carried out over a 6 years period, 2006‑2011. All teenage pregnancies (aged 13‑19 years) at Federal Medical Center Abakaliki, Ebonyi were taken as cases. Pregnancy deliveries from mothers aged 20 to 29 that met the inclusion criteria were selected as controls. A total of 137 teenage pregnancies were analyzed and compared with 948 controls. Statistical analysis was performed using 2008 Epi‑info statistical software version 3.5.1 (Atlanta, Georgia, USA). Results: The incidence of teenage deliveries over the period of the study was (137/8020) 2.25%. Single mothers were commoner (40.9% [56/137] vs. 3.1% [29/948], P < 0.01) among the teenagers. Low educational status was more common among teenage mothers (P < 0.01). Unbooked pregnancies were significantly common among teenage mothers (23.4% [32/137] vs. 12.3% [117/948], P < 0.01). Anemia in pregnancy (18.1% [41/226] vs. 11.2% [65/579], P = 0.01), human immunodeficiency virus (HIV) in pregnancy (4.9% [11/226] vs. 1.7% [10/579], P = 0.01) and malaria in pregnancy (26.1% [59/226] vs. 12.4% [72/579], P < 0.01) were significantly common in teenage pregnancies than the control. Teenage mother had significantly increased cesarean deliveries (23% [31/137] vs. 14.8% [140/948], P < 0.02), male deliveries (64.3% [90/140] vs. 52.1% [502/963], P < 0.03) and low birth weight (19.3% [27/140] vs. 12.7% [122/963], P < 0.03). Fetal loss (22.1% [31/140] vs. 3.3% [32/963] P < 0.01) and birth asphyxia (19.3% [27/140] vs. 6.8% [65/963], P < 0.01) were significantly common among teen mothers in the 1st min American Pediatric Gross Assessment Records score. Conclusion: Teenage pregnancies were associated with a significantly higher risk of anemia in pregnancy, HIV in pregnancy, malaria in pregnancy, cesarean deliveries and poor fetal outcome. Health education, women enlightenment and empowerment will be essential in reducing the problems of teenage pregnancy.