Maternal obesity has been associated with adverse pregnancy outcomes  such as pre–eclampsia, eclampsia, pre and post–term delivery, induction of labor, macrosomia, increased rate of caesarean sections and post–partum hemorrhage. The aim of our study was to determine the maternal risk in terms of antepartum, intrapartum, postpartum complications and perinatal outcome in relation to extremes of maternal Body Mass Index BMI. A total of 100 patients were studied and followed up till delivery. Any adverse pregnancy and perinatal outcomes were noted and the data was analyzed using Chi–square tests and percentages. Women with an above–normal BMI had a higher incidence of pre–eclampsia, induction of labor, caesarean section, pre–term labor, and macrosomia than women with a normal BMI (controls). Thus increased BMI increases the incidence of induction of labor, caesarean section, pre–term labor and macrosomia. The BMI of women in the first trimester of pregnancy is associated with the risk of adverse pregnancy and perinatal outcomes.