Background: Toxoplasmosis, Rubella, Cytomegalovirus and Herpes Simplex Virus-2 are infections affecting both mother and her fetus with adverse short and long term outcome to the fetus. Majority of infected mothers are asymptomatic and this leaves only speculation as to the probable cause of many congenital anomalies, still births, prematurity and death seen in neonates. The main objective of this study was to investigate the seroprevalence of Toxoplasmosis, Rubella, Cytomegalovirus and Herpes Simplex Virus-2 infections amongst pregnant women and their perinatal outcomes. Methods: This was a cross-sectional hospital based study conducted at Kilimanjaro Christian Medical Centre (KCMC) from December 2013 to April 2014. We recruited 350 pregnant women attending antenatal clinic and who opted to deliver at KCMC. ELISA testing for IgG and IgM for mothers and IgM only for neonates identified TORCH infections. Newborn of mother recruited for TORCH were follow up for first seven days of life. A structured questionnaire was used data collections for mothers and their newborn. Data analysis was done using SPSS version 20.0. Results presented into table and graphs. Odds ratio with the respective 95% CI were used to determine the strength of association between predictor and outcome. Results: The IgG seroprevalence of TORCH agents among pregnant women were 44.4% for T. gondii, 89.6% for Rubella, 98.6% for Cytomegalovirus (CMV) and 99.7%% for Herpes simplex virus type 1&2. For the IgM, Herpes 1 & 2 was the most prevalent infection 137 (39.5%) among the pregnant women included in this study. A total of 11 newborns were infected with herpes 1&2 giving a prevalence of 3.6%. Only one newborn was infected with rubella giving a prevalence of 0.3%. None of the newborn was infected with Toxoplasmosis or CMV. xii Conclusions: The prevalence of TORCH infection was higher among pregnancy women in our population. We observed newborn transmission rate was mainly for Herpes simplex virus, in which 3.6% of neonates born to mother with HSV were seropositive. The higher seroprevalence of Herpes simplex among women and their infants shows that Herpes simplex virus should be thought in case sepsis not responding to antibiotic treatment in neonates