Background: Thyroid dysfunction in pregnancy is one of the most prominent endocrinological disorders. Physiological changes in thyroid status and non-adaptation to these changes during pregnancy lead to thyroiddysfunction resulting in feto-maternal complications. Aim and Objective: To determine the current prevalence of thyroid dysfunction in normal pregnant women and to study the impact of thyroid dysfunction on maternal and fetal outcomes.Methods: This prospective study was conducted enrolling 115 pregnant women with thyroid dysfunction irrespective of their gestational age who came for antenatal check-up. Recent TSH, fT3, and fT4 values were noted, and whether the patient is on treatment or not was noted. The patients who were not on treatment were treated. These cases were followed up till the termination of pregnancy. TFT was repeated every 6-8 weeks or in each trimester, and in cases of deranged TFT, drug dosage was titrated accordingly. At the end, obstetric and perinatal outcomes of the pregnancy were noted. Results: Out of 115 subclinical hypothyroid (s.hypo) pregnant women, 15 (25%) of them had preeclampsia (PE), 1 (1.66%) had abruption, 13 (12.5%) had anemia, 3 (5%) of them had abortion, and 1 (1.6%) had PPH. Out of 15 overt (o.hypo) pregnant women, 6 (40%) had PE, 1 (6.7%) of them had abruption, 2 (13.3%) had anemia, 3 (20%) had abortion, and 1 (6.7%) of them had PPH. Out of 25 hypothyroid pregnant women in the (eu.hypo) state, 4 (16%) had PE, 2 (8%) had anemia, 1 (2%) of them had PPH, and none of them had abruption and abortion. Out of 3 subclinical hyperthyroid (s.hyper) pregnant women, 1 (33.3%) had PE. Out of 7 overt hyperthyroid (o.hyper) pregnant women, 4 (57.1%) had PE, and 2 (28.7%) of them had an abortion. Out of 5 hyperthyroid pregnant women in euthyroid (eu.hyper) state, none of them had any complications.Conclusions: Maternal thyroid dysfunction is associated with significant adverse effects on maternal and fetal outcomes.Emphasizing the importance of routine antenatal thyroid screening in the first trimester.