ObjectiveTo assess the efficacy of aspirin, prednisone, and multivitamin triple therapy in treating unexplained recurrent spontaneous abortion (URSA). MethodsData were reviewed from women with early RSA attending a hospital in Beijing, China, 2013-2017. Those with no abnormal indices (e.g., endocrine, coagulation, immune, genetic) were diagnosed as having URSA, and received aspirin, prednisone, and multivitamin therapy (triple therapy group, n=106) or folic acid monotherapy (control group, n=65). Treatment efficacy was evaluated as the rate of successful treatment (12-week pregnancy with obvious embryo and embryonic heart, nuchal translucency thickness <0.25 cm, size consistent with gestational age, no early malformation). ResultsOverall, 362 women had early RSA and 171 (47.2%) had URSA. The rate of successful pregnancy was similar between the triple therapy (89.6%) and control (92.3%) groups (P=0.343). The rate of successful treatment was higher in the triple therapy (86.3%) than in the control (53.3%) group (P<0.001). In multivariate logistic regression analysis, triple therapy was associated with higher odds of successful treatment, whereas the number of spontaneous pregnancy losses was associated with lower odds of successful treatment. ConclusionThe triple therapy of aspirin, prednisone, and multivitamin was found to be a good treatment option for women with URSA. A combination of aspirin, prednisone, and multivitamin therapy was found to improve clinical outcomes among women affected by unexplained recurrent spontaneous abortion.