Background: A high risk pregnancy sounds scary; it refers to anything that puts the mother or fetus at increased risk for poor health during pregnancy or childbirth. The aim of this study was to assess the levels of knowledge, attitudes and behaviors of women about the main maternal risk factors in pregnancy. Materials and Methods: A cross-sectional design was conducted. Setting: fromfour hospitals in Damietta governorate during the period of the study. Subjects: 220 pregnant women randomly selected Tool:  An interview questioner and likert scale were used for data collection. Results: About two third of studied sample (60.5%) were aged from25 to less than 35years old. Near half of them 45%was secondary school. About half of studied sample their housing near pollution 44.1%. One third of studied sample 30.5% had regular antenatal visit. More than half 58.6% of studied sample had knowledge about high risk pregnancy. Half of them 50.0% had sought hospitalization to promote their pregnancy from high risk. There is highly statistically significant relation between pregnancy out come and total attitude level significant found in between current pregnancy test and total knowledge level. Conclusion The results indicate that pregnant women lack knowledge regarding the main maternal risk factors. Recommendation: Our results suggest an urgent need for the design of interventions to improve women's levels of knowledge and to promote appropriate behavior in relation to the major risk factors in pregnancy.