The objective of this study was to describe the outcomes of the use of a combined therapy using progesterone and pessary in singleton gestation with a previous history of preterm birth and a short cervix in the mid-trimester. Prospective cohort study including patients consulting to our institution between 1 February 2019, to 31 December 2022 with singleton gestations, a past history of spontaneous preterm birth (SPB) and a short cervix (≤ 25 mm) between 18 to 24 weeks. A combined treatment with cervical pessary (CP) and vaginal progesterone (VP) (200 mg daily). The VP was continued until 34 weeks, the CP retired at 36 weeks or at the onset of labour. Pregnancy with contractions, bleeding, or RPM at the time of evaluation were excluded. The primary outcomes were spontaneous preterm birth before 35 weeks and perinatal mortality. During the study period, 52 patients who met the inclusion criteria were evaluated and were managed with CP and VP according to the study protocol. The mean gestational age at study enrolment was 20.1 weeks and the mean cervical length was 20.5mm. The mean gestational age at delivery was 36.3 weeks and the birthweight was 2814 gr. The percentage of preterm deliveries under 35 weeks in this series of cases was 11.5% (6/52) and perinatal mortality was 5.7% (3 /52). Combined treatment with CP and VP in low-income country, inpatients with SPB and short cervix in mid-trimester of pregnancy, shows apparently better obstetric results in this series of cases than those reported for the group of patients with these characteristics in the medical literature, when treated alone with vaginal progesterone or cervical cerclage with stitches. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.