Introduction: Obesity has become a global health problem and every year its prevalence is on the rise. The rise in obesity prevalence has been most prominent in women of reproductive age (postadolescent and premenopausal) with women tending to gain 0.5–1 kg each year from early adulthood until middle age. This has significant impacts on reproductive health in women as they enter pregnancy at a higher body mass index (BMI). The purpose of this study is to evaluate obstetric complications and perinatal outcomes in pregnant women with obesity (BMI ≥ 30.0 kg/m²). Materials and methods: In this prospective study, antenatal women with increased BMI (>30 kg/m²) were followed up in the outpatient department (OPD) of the Department of Obstetrics and Gynaecology from December 2020 to December 2021 at a tertiary care hospital in Amritsar, Punjab, India, and maternal complications and neonatal outcome were studied in them. Women were counseled on the optimization of body weight before planning further pregnancy. Results: The data revealed that 42.5% of the study participants developed gestational diabetes mellitus (GDM), 23.75% of the participants developed both GDM and hypertensive disorder of pregnancy (HDP), 17.5% developed only HDP, 12.5% developed fetal growth restriction (FGR), 3.75% of study participants lost to follow-up. Conclusion: Obesity is a clear contributor to a wide range of maternal and fetal complications. The risks associated with obesity in pregnancy cannot necessarily be influenced by the intervention. Preventive measures aiming at normalizing body weight before conception are thus the most important and rewarding.