To present our experience in the use of combination therapy with cervical pessary (CP) and vaginal micronised progesterone tablets (VMP) for the prevention of preterm birth (PP) in singleton pregnancies with cervical consistency index (CCI) ≤ 5th percentile in first trimester, routine scan, compared with historical matched controls. Prospectively, between January 1st, 2015 to December 31th, 2015, all singleton pregnancies evaluated in our unit institution, with cervical consistency index ≤ 5th percentile at 11 to 13.6, were offered combined treatment with CP and VMP 200 mg bid. The VMP was continued until 34 weeks, the CP retired at 36 weeks or at the onset of labor. Pregnancies with contractions, bleeding or RPM were excluded. The result was compared with historical controls matched week of gestation and CCI, 1:1 ratio. In the study group 10 patients, the mean gestational age at admission was 12.3 weeks, cervical length 37.4 mm and the average CCI was 51%, in the group of historical controls 10 patients, the mean gestational age at enrolment was 12.1 weeks, cervical length 40.4 mm and the CCI average was 53%. The mean gestational age at delivery in the study group compared to the historical control group was higher, 34.5 vs 28.7 weeks respectively, p = 0.013. Combined treatment with CP and VMP in patients with singleton pregnancies with CCI ≤ 5th percentile in 11–13.6 week, is feasible and shows a trend toward and fewer PTB compared to historical controls.