Background: Recurrent urinary tract infections (UTIs) pose widespread risks at some stage in pregnancy, such as pyelonephritis, preterm hard work, and occasional beginning weight. Prophylactic antibiotic regimens had been proposed to lessen the occurrence of recurrent UTIs among pregnant girls at excessive risk; but, proof helping their efficacy and safety remains varied [1,2]. Methods: A randomized controlled trial was performed in one center in pregnant women with a history of recurrent UTIs. The patients were divided into two groups: Group A was given continuous low-dose prophylactic antibiotics, (nitrofurantoin 50 mg/day), and Group B was given no prophylaxis but were followed up intensively. The main outcome was the rate of recurrent UTI during pregnancy. Secondary endpoints were gestational age at birth, birth weight, and undesirable maternal or neonatal outcomes. Baseline and monthly until birth urinalyses, urine cultures, and maternal-fetal evaluation were conducted. Statistical tests comprised chi-square for categorical variables and t-tests for continuous outcomes. Results: 200 pregnant women with a history of recurrent UTIs were recruited. The rate of recurrent UTIs was significantly lower in the prophylaxis group (15%) than in the control group (32%) (p<0.05). The frequency of asymptomatic bacteriuria during follow-up visits was also statistically lower in the prophylaxis group. There was no difference between the two groups in adverse maternal or neonatal outcomes. Low-dose nitrofurantoin was tolerated well, and compliance was high throughout the study. Conclusion: Low-dose prophylactic antibiotic treatment in pregnant women with a past historyof recurrent UTIs has been found to have a great decrease in the incidence of recurrence without an enhancement of adverse outcomes for the mother or neonate. These data endorse the therapeutic use of prophylactic antibiotics in high-risk pregnancies, as a means to enhance maternal and fetal well-being.