Purpose of Investigation: This study aimed to compare pregnancy outcomes based on parity in women older than 40 years. Materials and Methods: This retrospective cohort study included women older than 40 years with singleton pregnancy, who delivered after 24 weeks of gestation. They were divided into two groups on the basis of parity, and maternal and perinatal outcomes were compared. Results: This study included 432 women, with primiparous women (n=111) comprising a quarter among them. The mean parity of multiparous women was 1.8, and the mean interval from the previous pregnancy was 9.5 years. On analyzing multivariable logistic regression-adjusted confounding factors, small for gestational age (SGA) neonates (OR, 2.525; 95% CI, 11.407-4.529) were associated with primiparous women. The occurrence of preterm birth before 37 weeks of gestation (OR, 1.783; 95% confidence CI, 1.080-2.942) was increased in multiparous women. Conclusion: There are different pregnancy outcomes between primiparous and multiparous women. Preterm birth is more frequent in multiparous women, with an extremely long interval to subsequent pregnancy. The incidence of SGA newborns was higher among primiparous women.