Background: Bacterial vaginosis (BV) is a common vaginal infection in women of reproductive age, with potential adverse effects on pregnancy outcomes. Despite its prevalence, the specific impacts of BV during pregnancy and the effectiveness of its treatment protocols need further elucidation. Methods: This cross-sectional study involved 200 pregnant women recruited from a tertiary care hospital. Participants were screened for BV using the Amsel criteria and Nugent score. Data were analyzed to examine the prevalence of BV and its association with pregnancy outcomes, including preterm birth and low birth weight. Results: The prevalence of BV in the study population was 36%. Women with BV showed a significantly higher incidence of preterm birth (27.8% vs. 14.1%, P=0.022) and low birth weight (25% vs. 9.4%, P=0.004) compared to those without BV. Treatment for BV was associated with substantial improvements in symptoms and reductions in adverse outcomes, with treated women experiencing lower rates of preterm births and low birth weight compared to untreated cases. Conclusion: The study underscores a significant association between BV and adverse pregnancy outcomes. Effective screening and treatment for BV could potentially mitigate these risks, emphasizing the importance of integrating BV management into prenatal care protocols to improve maternal and neonatal health outcomes.