To assess the prevalence of malnutrition among Egyptian pregnant women and its effect on the pregnancy outcome, a comparative cohort study in which a total of 206 normal pregnant and 197 babies born to the pregnant subjects were enrolled. The study was conducted in El Sahel Teaching Hospital, Cairo, Egypt. Maternal anthropometry, blood parameters including hemoglobin (Hb) concentration, serum iron, total iron binding capacity (TIBC) and serum albumin were assessed. Patients were classified into 3 groups based on hemoglobin concentration. Pregnancy outcome was assessed by means of birth weight, length and Apgar score at birth. The mean Hb serum iron concentration, total iron binding capacity, and serum albumin were 10.332, 73.84, 382.74, & 3.846g/dl respectively; and 46% of the subjects were anemic. When subjects were classified into 3 groups based on the Hb levels, 16% fell into severe anemia category, while 30% of the subjects fell into mild anemia category. Statistically significant differences were found between each of maternal age & pre pregnancy BMI on one hand and the degree of anemia on the other hand. Comparisons between pregnancy outcomes in the three groups showed a statistically significant difference between gestational age, birth weight, birth length and Apgar score on one hand and the degree of anemia on the other hand. The incidence of preterm labor was much higher (65.6%) in the group of severe anemia than the other two groups.