Background: In vitro Fertilization (IVF) is an important alternative for infertile couples, there is an increase in the number of children conceived by IVF worldwide. Objective: The aim of this study was to assess the risk of birth defects and adverse outcome among infants and children conceived by in vitro fertilization in Sulaimani-Iraq. Patients and Methods: This case-control study was carried out on 160 children, 75 were product of IVF(using ICSI) and 85 were product of natural conception. Data collected regarding mother age, father age, duration of infertility before pregnancy with the index child, any complication during pregnancy, age of the child, gender, mode of delivery, gestational age, weight at delivery, history of neonatal admission and it’s cause, admission to hospital after neonatal period, and history of surgical operation. All children were examined for any gross anomaly, cardiovascular, respiratory, gastrointestinal, skeletal, urological and neurologic abnormality. Results: IVF was a risk factor for prematurity (OR, 7.844 95% CI 3.025 - 20.339) , LBW (OR, 4.645 95% CI 2.038 -10.587), Congenital anomaly (OR, 1.362 95% CI 0.720 - 2.576), predominance of male gender (OR, 1.340 95% CI 0.719-2.498), neuro-developmental delay(OR,1.333 95% CI 0.672-2.646), admission to NICU (OR,1.703 95% CI 1.052-2.758 ), C/S delivery (OR, 1.972 95% CI 1.507-2.581), and childhood hospitalization (OR, 1.193 95% CI 0.838-1.696), also there was statistically significant association with multiple pregnancy. Conclusions: IVF carries increased risk of LBW, prematurity, congenital anomaly, neuro-developmental delay, admission to NICU, childhood hospitalization, C/S as a mode of delivery and predominance of male gender.