: This study aimed to determine the prevalence of early pregnancy obesity among Omani women and to review maternal antenatal complications, intrapartum and postpartum events and neonatal com plications among such women in comparison to women of normal weight. Methods: This retrospective cohort study included 2,652 pregnant Omani women who delivered at the Royal Hospital, Muscat, Oman, between November 2011 and April 2012. The patients' electronic medical records were reviewed for antenatal, intrapartum and post partum data. Body mass index was measured during the first trimester (≤12 gestational weeks) and classified according to the World Health Organization categories. Maternal and neonatal complications were compared between obese women and those of normal weight. Obstetric outcomes in uncomplicated pregnancies were also compared. Results: In the study cohort, there were 901 (34%) obese women and 912 (34.4%) women of normal weight; of these, 440 (48.8%) and 672 (73.7%) had uncomplicated pregnancies, respectively. Obese women had a significantly increased incidence of gestational diabetes (relative risk [RR]: 2.23; 95% confidence interval [CI]: 1.70–2.92; P <0.01), gestational hypertension (RR: 3.04; 95% CI: 1.63–5.65; P <0.01), Caesarean delivery (RR: 1.48; 95% CI: 1.08–2.03; P <0.01), postpartum haemorrhage (RR: 2.10; 95% CI: 1.11–4.10; P = 0.01) and fetal macrosomia (RR: 2.71; 95% CI: 1.21–6.09; P <0.01). Conclusion: Approximately one-third of the studied Omani women were obese. These women had a significantly increased risk of various maternal antenatal complications, intrapartum and postpartum events and neonatal complications.