This retrospective study evaluates early first trimester FHR, gestational SACD, and CRL measurements as means to predict ultimate pregnancy outcome. Outcomes of 274 pregnancies were monitored a single time by transvaginal ultrasonography with measurements recorded between 5.0 and 9.0 weeks' gestation. The measurements were then correlated with the pregnancy outcomes. FHR (P < 0.0001), gestational SACD (P = 0.0002), and CRL (P = 0.0059) each correlated positively with a successful pregnancy outcome. Measurements from a single transvaginal ultrasonogram can be used to predict a successful pregnancy outcome in the early first trimester.