Objective <p>To evaluate whether hereditary thrombophilias and thromboprophylaxis are associated with live birth outcomes in patients with recurrent pregnancy loss (RPL).</p> Methods <p>This was a retrospective cohort study. We compared the odds of achieving a live birth in two groups of patients with RPL, those with hereditary thrombophilias and those without. Participants were seen at a tertiary referral centre specializing in the management of RPL. Hereditary thrombophilias were diagnosed by identifying Factor V Leiden (R506Q) or prothrombin mutation, or by detecting deficiencies in antithrombin, protein C, or protein S. We also evaluated the effect of thromboprophylaxis on live birth outcomes in patients with hereditary thrombophilias who conceived. Treatment options included aspirin, dalteparin (a low molecular weight heparin), hydroxychloroquine, and/or prednisone.</p> Results <p>Of the 458 patients with RPL included, 13.3% had hereditary thrombophilias, while 86.7% did not. There was no significant association between hereditary thrombophilias and live birth odds (adjusted odds ratio: 0.91; 95% confidence interval: 0.50–1.65). Of the 16 patients who received thromboprophylaxis, 56.2% achieved a live birth, compared to 39.1% in the untreated group, with no statistically significant difference (<i>P</i> = 0.342).</p> Conclusions <p>Hereditary thrombophilias and their thromboprophylaxis were not clearly associated with achieving live birth in the RPL population. However, these findings should be interpreted with caution. Larger studies are needed to verify these findings.</p>