To determine risk factors for recurrent spontaneous abortion (RSA) in women from southern China.We looked for associations between RSA and body mass index (BMI), family history of spontaneous abortion, smoking, exposure to environmental tobacco smoke (ETS [also known as passive smoking]), and alcohol and coffee consumption using an unconditional logistic regression model involving 326 patients with RSA and 400 controls.Whereas smoking, alcohol consumption, and coffee consumption were not associated with increased risk of RSA, both short (<1hour/day) and long (≥1hour/day) periods of ETS were associated (adjusted odds ratio [OR], 2.30; 95% confidence interval [CI], 1.50–3.52 and adjusted OR, 4.75; 95% CI, 3.23–6.99, respectively). The increased risk of RSA was significant for participants with a BMI of 24.0 or greater (adjusted OR, 1.54; 95% CI, 1.12–2.14) and those with a family history of miscarriage (adjusted OR, 2.12; 95% CI, 1.28–3.49).We found ETS, a higher BMI, and a family history of RSA to be independent risk factors for RSA in our population.