The purpose of this study was to assess the risk of persistence of transverse lie detected earlier in pregnancy and associated predisposing factors using follow-up ultrasound (US). A longitudinal study was carried out from January 2004 to august 2004 at Federal Medical centre, Lokoja, Nigeria. All singleton pregnancies, with ultrasound diagnosis of transverse lie, between 24-28 weeks were followed to term. At 24-28 weeks, 183 fetuses presented with transverse lie. Thirty seven were lost to follow-up; out of the remaining 146 babies, 22 persisted to term. Overall persistence rate was 15.1%. No identifiable predisposing factors were seen in 91.1%, placenta previa in 5.5%, lower segment fibroids in 2.7%, and ectopic kidney in 0.7%. In conclusion, transverse lie detected early in pregnancy is transient, and majority would convert to a longitudinal lie at term. Potential predisposing factors highlighted above increases the risk of persistent transverse lie at term, with placenta previa and lower segment fibroids being the major predisposing factors.