The purpose of this study was designed to explore the value of placental volume and placental vascularization indices in prediction of neonatal outcome in pregnant women with antiphospholipid syndrome. Patient and Methods: Seventy (70) pregnant women were categorized into 2 groups; Group A: control group (35 cases); Group B: antiphospholipid group (35 cases). The perinatal outcomes were correlated to the results of placental volume and placental vascularization indices. The accuracy of placental volume and placental vascularization indices in the prediction of adverse outcome were calculated. Results: placental vascularization indices, VI, FI and VFI were lower in group B in 1st and 2nd US scans with statistically significant P values (<0.05). Also placental volume was lower in antiphospholipid group in 1st and 2nd US scans with statistically significant P values (<0.001). There was a significant correlation between the two groups concerning the gestational age at termination of pregnancy, Apgar score and birth weight (with P-value < 0.05). Moreover, IUGR in group B was significantly correlated to placental volume and placental vascularization indices. Conclusion: From our study we could conclude that placental volume and placental vascularization indices are good utilities for the assessment of fetal wellbeing and prediction of neonatal outcome in pregnant women with antiphospholipid syndrome.