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PURPOSE To evaluate live birth rates and prevalence of congenital anomalies for couples undergoing Intrauterine Insemination (IUI) with abnormal sperm morphology (<4% normal forms). MATERIALS & METHODS We retrospectively reviewed IUI outcomes from January 2012 to March 2015. Patients who were found to have an ultrasound confirmed clinical pregnancy were contacted to determine live birth rates and prevalence of congenital abnormalities. Chi-squared analysis was used to assess categorical variables, student-T test was used to assess continuous variables. Logistic regression was used to assess odds of achieving a pregnancy and risk of spontaneous abortion while assessing for female age, total motile count, and sperm morphology. RESULTS Of 984 IUI performed on 501 couples, we found no difference in ultrasound clinical pregnancy rate for couples with a sperm morphology <4% vs. ≥4% (12.3% vs. 13.6%, p = 0.59). Of those 130 couples that had an ultrasound confirmed clinical pregnancy, we collected live birth and birth abnormality data from 95 couples (73% response rate). We found no difference in live birth rates or spontaneous abortions after an ultrasound confirmed clinical pregnancy for couples with an abnormal sperm morphology (<4% normal forms). There was also no increased risk of birth abnormalities for patients with abnormal sperm morphology. CONCLUSION Abnormal sperm morphology neither impacted pregnancy rates nor live birth rates in couples undergoing IUI. These results can be used to reassure couples undergoing IUI that there is minimal impact of abnormal sperm morphology on live birth rate and prevalence of birth abnormalities.