The etiology of preterm birth is mostly underestimated in developing countries. Current presumptions are that both environmental and genetic factors contribute towards its onset and are responsible for the higher frequency of neonatal deaths. Despite there being considerable scientific data on preterm births across the world, the frequency of its occurrence and threat to the survival of neonates are alarming. It is important that variations among populations should be considered as the socioeconomic status, climatic zones and other genetic, as well as epidemiological factors vary, so as to draw definitive conclusions on the pathogenesis of preterm birth. Predictive biomarkers, prevention and optimum treatment strategies are still being discovered, but with well-designed studies and collaborative efforts, maternal and child healthcare can be prioritized. The purpose of this review is to understand the contributing factors of preterm birth as it is a critical issue and needs in-depth understanding with planned scientific studies to decrease the rate of preterm birth and complication related to it. Furthermore, the review enlists various factors linked to preterm birth viz, high maternal age, psychological state, environmental contaminants, infection, cervical length, addiction, cytokine interaction, preeclampsia, genetic composition, ethnicity, oxidative stress and microRNAs. We have summarized the status of preterm birth, its causes, and future line of work required to prevent mortality of mother and neonate that will help us design successful studies which aim to reduce preterm births effectively. © 2020 Asian Pacific Journal of Reproduction Produced by Wolters Kluwer-Medknow.