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Background: Antiphospholipid antibody syndrome (APS) is an increasingly recognized cause of recurrent pregnancy loss and preeclampsia. Diagnosis and management of Obstetric APS has evolved rapidly over the recent years. While the mainstay of management of the condition is low molecular weight heparin and aspirin, additional agents are being attempted due to the lack of completely satisfactory outcomes despite treatment. The addition of hydroxychloroquine (HCQS) is an important option that has not yet been adequately studied, forming the basis of the present study. Materials and methods: A prospective observational comparative study was conducted in a tertiary care hospital that caters to patients with this condition. Patients with Obstetric APS managed and delivered in the institution were studied. Being an observational study, decisions of patient management were independent of the present study. Patients were divided into 2 groups: 1. Those receiving low molecular weight heparin + aspirin + HCQS 2. Those receiving low molecular weight heparin + aspirin Demographic parameters, obstetric history parameters, obstetric outcomes, and neonatal outcomes in the present pregnancy were compared between the groups. Results: Twenty-nine patients [17 patients receiving low molecular weight heparin (LMWH)  +  aspirin  +  HCQS and 12 patients receiving LMWH + aspirin] were studied. Comparison showed higher usage of HCQS in patients with Obstetric APS with coexisting autoimmune comorbidity (70.5 vs 8.3%, p-value 0.001), and those with coexisting ITP (58.3 vs 8.33%, p-value 0.027). Group with HCQS showed a much lesser proportion of hypertensive disorders (17 vs 58%, p-value 0.046), but a much higher need for platelet transfusion (47 vs 10%, p-value 0.027). The delivery and neonatal outcomes were similar in both groups