Background: The rapid upswing in obesity prevalence across nations, ages, and ethnic groups has reached pandemic proportions. There is a significant increase in the incidence of obesity with a prevalence of 2%–55% in adult females. Aims of the study to assess the hospital based rate of obesity among high risk pregnant women at Qena University Hospital, assess the antenatal obstetric and medical complications associated with obesity among these women, and provide health education about the dietary requirements. Subjects and methods Cross Sectional research design was carried out in this study. A simple random sample of high risk pregnant women (350) seeking care at Qena University Hospital were recruited. A Screening sheet used for detecting the rate of obesity by anthropometric measurements, then for obese women: a structured interviewing questionnaire was used to complete socio-demographic data, obstetric history, maternal medical history, family history, current antenatal risk factors associated with Obesity. The main results: more than half (57.4%) of high risk pregnant women were classified as obesity class one. Obese women were at increased risk of pregnancy complications such as previous caesarean section (38.3%), premature rupture of membrane were (13.4%), pregnancy induced hypertension (11.7 %). Conclusion hospital based rate of obesity was one third of the total flow of pregnant women at this hospital was obese with high risk pregnancy and the most common obstetrics' complications associated with obesity were previous caesarean section and premature rupture of membrane respectively.