Background & Objective(s): Anaemia is considered the most frequent complication related to pregnancy. It is also the most common preventable cause of fetal and maternal mortality and morbidity. Despite the routine use of iron and folate supplementation for prevention of anaemia in Egypt, the prevalence of anaemia is still high This study was conducted to estimate the occurrence of anaemia and investigate the relationship between maternal anaemia and perinatal outcomes at Karmouz Family Health Unit in Alexandria. Methods: The study involved 206 pregnant women in third trimester. It was conducted on two phases: First, a cross sectional study using an interviewing questionnaire to collect data about sociodemographic profile and drug history. Laboratory data was collected from records to estimate the occurrence of anaemia. Then, a prospective cohort study was carried out using a follow up sheet to assess perinatal outcomes of maternal anaemia. Results: The results of our study show that the occurrence of anaemia among studied pregnant women was high (73.8%). Most of the women who did not regularly receive iron supplementation were anaemic. Maternal anaemia was shown to be significantly associated with preterm labor, low birth weight, congenital anomalies, small head sized babies and neonatal intensive care admission. Moreover, hemorrhage and infection were significantly encountered maternal complications. Conclusion:  Irregular intake of iron supplementation during pregnancy was significantly associated with anaemia. Moreover, maternal anaemia was significantly related to maternal and neonatal complications.