Aim: To evaluate uterine artery Doppler flow resistance and plasma adrenomedullin levels in women with unexplained recurrent pregnancy loss (RPL) compared to controls. Material & Methods: Eighty-three women, who attend the department of Obstetrics and Gynecology, Benha University, Egypt, participated in this study (RPL group: n = 40, and control group: n = 43). Uterine artery Doppler and plasma adrenomedullin (AM) (pg/mL) levels were measured for all women in the mid-luteal phase of a non-pregnant cycle. Results: Both uterine artery pulsatility index (PI) and AM levels were significantly higher in RPL group compared to controls (2.71  0.259 vs 2.06  0.194 for PI and 287.5  80.4 pg/mL vs 156.1  39.8 pg/mL for AM, P < 0.01). Uterine artery PI had a significant positive correlation with plasma AM levels both in the RPL group (r = 0.645, P < 0.001) and in the control group (r = 0.384, P = 0.011). Number of previous miscarriages in RPL group was significantly correlated with both uterine artery PI (r = 0.838, P = 0.015) and plasmaAM levels (r = 0.509, P = 0.001). Conclusions: Uterine artery PI may be useful in identifying women with unexplained RPL who have impaired uterine circulation. Plasma AM may serve as a biochemical marker for RPL caused by impaired uterine perfusion.