Background: One of the goals of the antenatal clinic is to prevent and recognize adverse pregnancy outcomes (APO). APO include hypertensive diseases of pregnancy, pre-term birth, pregnancy loss and maternal death. Our objective is to investigate the knowledge and attitude of mothers on risk factors of developing APO in Saudi Arabia. Methods: A cross-sectional study of female school teachers was conducted. 195 women were selected from four different schools in the region. Inclusion criteria were women of reproductive age who had at least one previous pregnancy. A self-administrated questionnaire on the knowledge and attitudes of risk factors that influence pregnancy outcomes were used. Results: 192 out of 195 mothers completed the questionnaire (98.4% response rate). The mean age of those women was 33.6. Responses revealed that most women have good knowledge about the risks resulting from malnutrition, diabetes, and drug abuse as the agreement on all of these statements were 80%. However, their knowledge about the importance of maternal education and their attitude towards cesarean section was not satisfactory. Conclusion: Although our sample was an educated group; low knowledge was detected in essential items. This study revealed that the public had extremely low knowledge regarding cesarean section, the importance of maternal age during pregnancy and how mother education can affect the delivery of her newborn. We recommend that pregnant women should be educated in the importance of attending the antenatal clinic regularly.