Background: Antepartum hemorrhage (APH) during pregnancy has a significant impact on both mothers and neonates. Aim: This study aims to investigate maternal and neonatal outcomes by retrospectively analyzing placenta previa (PP) cases complicated by APH. Methods: This study retrospectively investigated 50 cases of singleton pregnancies in women diagnosed with PP managed at a tertiary care Hospital in Karachi, Pakistan, from January to October 2024. The participants recruited were of a gestation period ranging from 24 to 42 weeks. The participants were categorized into two groups: APH and non-APH. The study assessed various maternal clinical characteristics. Ultrasound exams were conducted using standardized methods. Perinatal outcomes for mothers and newborns were compared, including complications such as preterm delivery, placental abruption, and neonatal issues. Mann–Whitney U test, Student’s t-test, Chi-square test, and binary logistic regression were employed for statistical analysis. Results: Women afflicted with APH exhibited significantly higher maternal age compared to those without APH (p=0.029). Furthermore, we discovered a notable statistical difference in the type of PP between the two groups. Specifically, complete PP was observed in 27.3% of women with APH but only in 4.3% of those without APH. The gestational age at delivery for pregnant women with APH was notably shorter compared to those without APH, leading to a considerably higher incidence of both lower birth weights and preterm deliveries when APH was present, in contrast to cases where APH was absent. Conclusion: APH has a significant association with maternal and neonatal outcomes, especially in cases of PP. Thus, timely interventions are necessary to prevent APH to mitigate further complications in mothers and newborns. Relevance for Patients: The research demonstrates why prompt diagnosis and on-time care interventions improve maternal–fetal health outcomes during APH incidents, specifically in PP patients.