Background: Gestational diabetes mellitus (GDM) is the most prevalent metabolic disorder during pregnancy. It is described as the vulnerability to impaired glucose tolerance of multiple severities, usually during pregnancy. Objective: To compare pregnancy outcome in pregnant women with gestational diabetes mellitus and pregnant women in general population. Patients and Methods: A prospective non-intervention observational study was conducted in Obstetrics and Gynecology Department, Faculty of Medicine, Al-Azhar University, Samanoud General Hospital and Private Clinics during the period from October 2017 to October 2020. This study included 200 primigravida singleton pregnant women between 24 weeks and 28 weeks of gestation divided into two equal groups: case group included pregnant women attended for their routine antenatal care and discovered to have gestational diabetes and control group included normal healthy pregnant women attended for their routine antenatal care. Results: Fetal weight was significantly higher among study group than controls. Fetal complications in the form of Large for Gestational Age (LGA), premature, shoulder dystocia, hypoglycemia and hyperbilirubinemia were significantly higher among study group than controls. Neonatal Intensive Care Unit (NICU) admission was significantly higher among study group was (14%) than controls (3%). Conclusion: Increased maternal and fetal morbidity is linked with maternity gestational diabetes. Early screening, diagnosis, closer monitoring, and intervention were also important to minimize short and long-term maternal and fetal adverse effects, in particular in populations that are high-risk.