Aim: To investigate the histopathological changes in ocular tissues of women diagnosed with gestational diabetes mellitus (GDM) and to assess their correlation with glycemic control and adverse pregnancy outcomes. Material and Methods: A total of 100 women aged 25–40 years with confirmed GDM were included in this study. Ocular tissue samples were collected postpartum and analyzed using histopathological and immunohistochemical techniques to evaluate microvascular proliferation, basement membrane thickening, cellular degeneration, and VEGF expression. Clinical data, including HbA1c levels and pregnancy outcomes, were recorded and statistically analyzed to determine associations between histopathological changes and clinical parameters. Results: Histopathological analysis revealed significant changes in retinal and choroidal tissues. Retinal microvascular proliferation (65%), basement membrane thickening (75%), and VEGF overexpression (80%) were strongly correlated with elevated HbA1c levels. Similar changes were observed in the choroid, albeit less pronounced. Scleral tissue exhibited minimal alterations. Adverse pregnancy outcomes, including preterm delivery (35%), neonatal hypoglycemia (25%), and preeclampsia (20%), were significantly associated with ocular changes. Multiple regression analysis identified HbA1c as the strongest predictor of histopathological changes, with earlier diagnosis associated with reduced severity of vascular damage. Conclusion: This study demonstrates significant ocular histopathological changes in women with GDM, strongly linked to poor glycemic control and adverse pregnancy outcomes. These findings emphasize the importance of stringent glycemic management and multidisciplinary care to prevent systemic and ocular complications in GDM.