Background: Premature birth is the leading cause of newborn morbidity and mortality. This study sought to evaluate the outcomes of preterm delivery in El-Obeid, Sudan. Methodology: A prospective descriptive study was conducted in the Obstetrics and Gynecology Hospital in El-Obeid, North Kordofan State, Sudan, from January 2023 to December 2024. The study encompassed approximately 106 hospitalized women with a gestational age below 37 weeks. Results: The largest G.A. at risk were 34 weeks, followed by 35 weeks, with figures of 26/106 (24.5%) and 20/106 (19%). The majority of deaths occurred at 30 G.A. (27%). The most common risk factor was premature rupture of membranes (PPROM), followed by postpartum hemorrhage (PPH), which accounted for 45% and 39%, respectively. Antepartum hemorrhage caused the majority of deaths (49%) in Sudan. Conclusion: Preterm birth is widespread in Sudan, with severe consequences, the most common being death. Although postpartum hemorrhage is the most common risk factor, antepartum hemorrhage is becoming more closely associated with death.