To report on our 5 years of experience with a universal screening program for preterm birth (PTB), using transvaginal ultrasound for cervical length (CL) measurement at time of 2nd trimester anatomy scan. We performed a retrospective analysis of patients with nonanomalous singleton gestations diagnosed with short CL in our tertiary medical center between Oct 2012 and Dec 2017 identified through our universal screening program. Screen positive was defined as CL <25mm in women at high risk (HR) for PTB, based on their obstetrical history, and <20mm for those considered low risk (LR). Program acceptance, screen positive rates, and gestational outcome were evaluated. The HR group was compared to LR for maternal, gestational and neonatal outcome data. During the study period 25,939 of 27,952 (92.8%) women who had 2nd trimester anatomy scans elected CL screening. 430 (1.66%) patients were deemed screen positive: 135 (0.52%) in the HR group (CL <25mm) and 295 (1.14%) LR (CL <20mm). LR women were younger (29 vs 30.5 yrs., p=0.018) and had lower gravidity (3 vs 5.4, p<0.001) and parity (0.56 vs 1.75, P<0.001) than HR. There was no difference in gestational age at diagnosis, ethnicity, or BMI. 181 (42%) delivered <37 weeks. 19/135 HR women (14%) were receiving 17-Hydroxyprogesterone. HR women used vaginal progesterone and cerclage equally (28%) and LR women used vaginal progesterone (55%) more frequently than cerclage (18%).Groups were similar for gestational age at birth (34w1d HR vs 34w0d LR, p=0.78), neonatal death (6.67% HR vs 10.2% LR, p=0.22) and admission to NICU (29% HR vs 27% LR, p=0.76) but HR neonates had higher rates of necrotizing enterocolitis (6% vs 0.3%, p<0.001). The mean CL was shorter in the women who received cerclages (1.19 vs 1.66, P<0.001) and they were more likely to be high risk gravidas (P<0.001). There was no difference in neonatal outcomes between women using vaginal progesterone vs cerclage. Universal screening for PTB using transvaginal ultrasound for CL at time of 2nd trimester anatomy scan is highly acceptable to patients. Over two thirds of screen positive patients were considered low risk for PTB and would not have otherwise been identified and eligible for PTB preventative interventions.