Cytomegalovirus (CMV) is the most common congenital viral infection, affecting 0.5–2% of all live births worldwide. Primary maternal CMV infection in the first trimester carries a high morbidity and mortality for the fetus. Herein, we present a case of a 27-year-old primigravida who tested positive for primary CMV infection in the first trimester. The patient experienced fever, fatigue at 8 weeks of gestation. Laboratory investigation revealed elevated inflammatory markers, and CMV serology was consistent with a recent infection (CMV IgM and IgG were positive). She was started on high-dose valacyclovir till amniocentesis then stopped by her self she cannot tolerate and sent for serial fetal evaluations. Fetal CMV was indicated by positive PCR of amniotic fluid at 16weeks. However, ultrasonographic monitoring during pregnancy revealed no structural anomalies other than quarry unilateral cataract at 26weeks. The patient gave birth to a healthy female newborn at term by induced vaginal delivery. Fetal Urinary CMV PCR was positive postnatally. Audiology examination showed bilateral hearing impairment, and the baby commenced on oral valganciclovir. This case highlights the importance of early detection of maternal CMV infection, treatment with antivirals, and the necessity of multidisciplinary antenatal and postnatal monitoring to optimize neonatal outcomes in CMV infection.