Preterm birth (PTB) is a global public health concern, contributing significantly to neonatal morbidity and mortality. This chapter outlines the complex and multifactorial nature of the preterm labour syndrome, examining both spontaneous and iatrogenic triggers. The aetiology, epidemiology, and risk factors are discussed alongside current strategies for prediction and prevention, including cervical length screening, biochemical markers, and lifestyle modifications. The role of infection, inflammation, and hormonal pathways is critically analysed. Additionally, this chapter reviews evidence-based preventive interventions and explores emerging research aimed at improving maternal-fetal outcomes. A syndromic approach is emphasised as vital for clinical management and future investigations.