Preterm birth is the leading cause of perinatal morbidity and mortality in the United States. The risk of preterm birth is inversely proportional to the length of the cervix on transvaginal sonography. The traditional treatment for a short cervix has been cerclage and recently there are newer trials using progesterone for this same indication. This manuscript reviews the published data regarding the use of an old method for the treatment of cervical insufficiency, "The Cervical Pessary." A MEDLINE search was performed and articles published since 1959 regarding the use of pessary for cervical insufficiency were identified and reviewed. The pessary may represent an easy and safe intervention in the treatment of a short cervix diagnosed in the midtrimester. Further research is merited to evaluate the role of the cervical pessary as an alternative treatment for a short cervix or for women at high risk for preterm birth.