Obesity before pregnancy is associated with an increased risk of several adverse outcomes of pregnancy. This study was done to evaluate the waist circumference as an anthropometric parameter in identifying women at risk of developing obesity related adverse pregnancy complications. It was a prospective clinical study comprising 74 antenatal women with singleton pregnancy attending the antenatal clinic of a tertiary care centre in South India from January 2016 to October 2017 before 12 weeks of gestation. Of the 74 studied patients, pre–eclampsia was the commonest followed by post dates seen in patients with obesity. Waist circumference can be used as an anthropometric parameter to assess the pregnancy risk and related adverse outcomes suggesting all pregnant women with central adiposity to be considered as high risk and also help in pre–conception counselling.