Background: Protein Z (PZ) is a vitamin K-dependent plasma glycoprotein, it plays a key role in the physiologic inhibition of coagulation by acting as a cofactor in the inactivation of factor Xa. The relationship between PZ gene polymorphisms and pregnancy loss is controversial. To address this, we investigate the association between PZ (rs3024718, rs3024719, rs3024731, rs3024778 and rs3024772) single nucleotide polymorphisms (SNPs) and idiopathic recurrent pregnancy loss (IRPL) in in women from Tabuk region (North western region, Saudi Arabia). Methods: A case control study, including Sixty-three women with at least three unexplained recurrent pregnancy loss (RPL) were selected and matched with seventy-eight healthy and fertile women (controls). SNP genotyping was carried out by allelic discrimination using real time PCR. Results: The outcome was that the minor allele frequencies (MAF) are 0.23 vs 0.20, 0.24 vs 0.19, 0.02 vs 0.02, 0.26 vs 0.21, and 0.02 vs 0.01 respectively for rs3024718 A/G, rs024719 G/A, rs3024778 G/A, rs3024731 G/A, and rs3024772 A/G PZ polymorphisms. The genotype distribution was similar between women with RPL and control women (P>0.05) and none of the tested SNPs were associated with RPL under co-dominant, dominant, or recessive genetic models. The lack of association was also confirmed by haplotypes analysis showing an absence of RPL risk with the constructed haplotypes. Conclusion: It was concluded that the studied PZ polymorphisms are not associated with the risk of recurrent pregnancy loss in the studied population
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