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Introduction: The prevalence of obesity among women is an increasing problem, especially in urban population due to sedentary lifestyles and altered dietary habits. Maternal obesity has consequences on pregnancy and perinatal outcome. The present study was conducted to determine the impact of maternal obesity on maternal and perinatal outcome. Materials and Methods: A prospective hospital-based study was conducted on 176 pregnant women with body mass index (BMI) <25 kg/m2 and 166 pregnant women with BMI ≥25 kg/m2. Data on maternal outcomes and perinatal outcomes were collected by following up on antenatal women till the end of the pregnancy and results were analyzed among the two groups using SPSS version 27. Results: Around 31.3% of pregnant women with BMI ≥25 kg/m2 had developed gestational hypertension, 22.9% had gestational diabetes mellitus (GDM), 7.8% had preeclampsia/eclampsia, 9.6% had prolonged labor, and more than half (53%) of them had emergency lower segment cesarean section (LSCS). Less than 1/3rd of pregnant women with BMI ≥25 kg/m2 had induction of labor and perineal injuries. Association of gestational hypertension, GDM, preeclampsia/eclampsia, prolonged labor, and mode of delivery (emergency LSCS) was found to be significant with maternal obesity. About 16.9% and 7.2% of pregnant women with BMI ≥25 kg/m2 had preterm and postterm delivery, respectively. Only 0.6% of pregnant women with BMI ≥25 kg/m2 had weight of newborn >4 kg. Conclusions: Maternal obesity leads to adverse maternal and perinatal outcomes and is an important contributor to the burden of obstetric care. Thus, effective intervention is required in preconception period to reduce the obstetric complications.