Background <p>Teenage pregnancy is a significant public health issue globally due to its association with a range of adverse health, socio-economic, maternal, and neonatal outcomes.</p> Aims <p>This study therefore examined the prevalence and outcome of teenage pregnancy in a state specialist hospital, Osogbo, Osun State, Nigeria.</p> Methods <p>This study is a ten-year retrospective study conducted to determine the prevalence and outcome of teenage pregnancy. The sample consisted of 225 teenagers aged 13–19 years registered for antenatal and delivery services in State Specialist Hospital, Osogbo, Osun State, using total enumeration. Data were extracted from medical records of patients and hospital databases using a proforma. Data extracted were analyzed using descriptive statistics of frequency and percentages, while inferential statistics of chi-square were used to establish relationships between the variables.</p> Results <p>The findings showed a 5.4% prevalence of teenage pregnancy, with the majority being aged 18 years, 55 (24.4%), at a gestational age of 36–40 weeks (79.6%), unmarried 129 (57.3%), with secondary education 118 (52.4%). The majority had no previous obstetric history, 124 (55.1%); however, 44 (19.6%) had abortions. Most teenage pregnancies recorded ended with live births, 152 (67.6%), with a significant number of preterm births, 59 (26.2%). Neonatal outcomes showed normal weight 141 (62.7%) and low birth weight 62 (27.6%). Anemia 29 (12.9%) was high among other complications as observed from the study. However, less than half of the pregnancies were delivered through caesarean section, 91 (40.4%).</p> Conclusion <p>This study showed a low prevalence of teenage pregnancy among teenagers aged 15–19 years, indicating that teenage pregnancy still exists despite efforts to empower teenagers on sexuality education. Therefore, more effort should be intensified to advocate for targeted interventions to drastically reduce pregnancy among teenagers.</p>