We evaluated the association between the use of intermittent preventive treatment with sulphadoxine- pyrimethamine (IPTp-SP) on pregnancy outcomes among women who delivered at a secondary hospital in Nsukka, Enugu State, Nigeria. Relevant obstetric data (e.g. IPTp-SP use), matched against pregnancy outcome data such as delivery method, stillbirth, maternal haematocrit test results and babies’ birth weights, were collected retrospectively from antenatal care (ANC) case files of women who delivered within a one-year period (2013). The prevalence of adverse pregnancy outcomes recorded out of the 500 ANC case files analysed were: low birth weight (LBW) 3.6% (15), anaemia 54.3% (114), caesarean section 31.6% (156) and stillbirth 3.6% (67). A total of 342 (68.4%) of the women received IPTp-SP during ANC and the receipt of IPTp-SP was significantly associated with reductions in the following events: LBW [OR = 0.26, 95% CI = 0.09 – 0.75], moderate anaemia [OR = 0.33, 95% CI = 0.17 – 0.63], caesarean section [OR = 0.36, 95% CI = 0.24 – 0.53] and stillbirth [OR = 0.10, 95% CI = 0.06 – 0.18]. In this area of high malaria transmission we demonstrated significant reductions in unfavourable maternal and infant health outcomes when using IPT-SP.