Objective: To examine the associations between a history of recurrent miscarriage (RM) and obstetric and perinatal outcomes in the subsequent pregnancy. Design: Retrospective cohort study. Setting: A large tertiary maternity hospital in Shanghai, China. Population: 118,375 deliveries booked for antenatal care and delivery between 01/2014 and 08/2021. Methods: Obstetric and perinatal outcomes were compared among 1,994 women (1.83%) with a history of two or more miscarriages (RM), 11,477 women (10.55%) with a history of one miscarriage, and 95,321 women (87.62%) with no history of miscarriage, respectively. Logistic regression analyses were performed, adjusting for potential confounders. Main Outcome Measures: Obstetric complications included gestational diabetes mellitus, preeclampsia (sub-classified as preterm and term preeclampsia), placenta previa, placenta accrete, foetal distress, and preterm pre-labour rupture of membranes (PPROM). Perinatal outcomes included mal-presentations, induction, post-partum haemorrhage, preterm birth, stillbirth, Apgar score <7, neonatal asphyxia, neonatal sex, and congenital malformation. Results: There was an increased risk of adverse obstetric and perinatal outcomes in a subsequent pregnancy for women with a history of RM, including placental dysfunction disorders [preterm preeclampsia (odds ratio [OR]=1.60; 95% confidence interval [CI]: 1.03-2.50), PPROM (OR=1.39; 95% CI: 1.10-1.75), preterm birth (OR=1.40; 95% CI: 1.19-1.64)], and abnormal placentation (placenta previa [OR=1.79; 95% CI: 1.38-2.34], and placenta accrete [OR=4.25; 95% CI: 2.84-6.37]), after adjusting for relevant confounders. Conclusions: Significant associations existed between RM and adverse obstetric and perinatal outcomes like placental dysfunction disorders and abnormal placentation. Careful surveillance is required in pregnancies following RM, for early detection of possible complications.