Background: Iron deficiency is the most common nutritional deficiency worldwide, particularly among pregnant women. Because of the increased iron requirements during pregnancy, pregnant women are recognized as the group most vulnerable to iron deficiency anemia. Objective: To evaluate the effect of moderate maternal iron deficiency anemia on maternal outcome (Atonic postpartum hemorrhage or postpartum infections after delivery), and fetal outcome (neonatal weight and Apgar score). Patients and methods: This was a prospective cohort study carried out at Om El-Masryeen General Hospital on 100 pregnant females, during the period from June 2020 to December 2020 who were admitted to the labor ward for delivery, Before delivery blood samples were collected. They were classified into two equal groups according to hemoglobin level. Group 1 (non-anemic group) included pregnant women with hemoglobin level 11 g/dl or more and group 2 (anemic-Group) which included pregnant women with moderate iron deficiency anemia who had hemoglobin level ranging from 7 to <10 g/dl. The patients were delivered either vaginally or by cesarean section according to obstetric indication. After delivery, maternal outcome was assessed for atonic postpartum hemorrhage or postpartum infections after delivery and all newborns were assessed for neonatal weight and Apgar score. Results: There was a significant difference of the demographic residence between both study groups (P<0.05) with higher number of candidates with moderate anemia residing in rural areas. After delivery, the rate of atonic postpartum hemorrhage among anemic group (10%) was higher than that among the non-anemic group (2%). The rate of postpartum endometritis among anemic group (6%) was found to be also higher than that among non-anemic group (2%). The rate of post-cesarean wound infection among anemic group (6.3%) was found to be also higher than that among non-anemic group (0%). The rate of episiotomy wound infection among anemic group (4%) was found to be also higher than that among non-anemic group (0%). There were positive correlations between the maternal parameters (maternal serum hemoglobin, mean corpuscular volume, means corpuscular hemoglobin, serum iron and serum ferritin) and the fetal outcomes (neonatal weight, Apgar score at 1st and 5th minute). There were negative correlations between maternal total iron binding capacity (TIBC) and the fetal outcomes (neonatal weight, Apgar score at 1st minute and 5th minute). Conclusion: Maternal iron deficiency anemia affected both maternal outcome (atonic postpartum hemorrhage and postpartum infections after delivery), and also fetal outcome (neonatal weight, Apgar score at 1st and 5th minutes).