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There is concern for very obese women and their pregnancy outcomes as obesity confers increased risk of maternal and perinatal complications. This study aims to determine the prevalence of obesity in pregnancy and the maternal and foetal risk of adverse pregnancy outcome in relation to maternal obesity. This prospective study was carried out at the University of Port Harcourt Teaching Hospital (UPTH) between May 2006 and April 2007. A cohort of 150 pregnant women with BMI≥ 30kg/m2 who registered for antenatal care were identified and compared with a control group of 150 non-obese pregnant women. The incidence of obesity in the study was 6.0%. More of the obese patients were of low parity. Sixty percent of the obese women had tertiary education. Preeclampsia (14%), malpresentations (5.3%) and prolonged pregnancy (24%) were significantly more common in the obese group. The Caesarean section rate was also higher in the obese group (p< 0.001). Foetal macrosomia and birth asphyxia were significantly higher among the obese group (p= 0.001). Pregnancy in obese women presents a certain amount of risk and there is need for close surveillance to reduce these obesity-related complications in pregnancy.