Background: Pregnancy-related acute kidney injury (PRAKI) is a significant global health concern, causing severe AKI in young women during pregnancy, labor, and the postpartum period, leading to adverse maternal and fetal outcomes. Identifying contributing factors is essential for better management and outcomes. Methods: A prospective observational study was conducted in pregnant women above 18 years of age who were admitted with PRAKI and post-delivery. Patients with pre-existing renal disease or AKI unrelated to pregnancy were excluded. Data was collected on demographics, urinary output, antenatal care, laboratory investigations, hospital stay, mode of delivery, etiological factors, and recovery outcomes. Results: Among 46 patients, 58.7% were primigravida, and 41.3% were in the postpartum period. Obstetric complications, including postpartum hemorrhage (32.6%), and pregnancy-specific disorders like pre-eclampsia (26.1%) were the main causes of PRAKI. Most patients experienced oliguria (71.7%), and common laboratory abnormalities included elevated serum creatinine (91.3%) and uric acid (82.6%) levels. Most patients achieved complete recovery (47.8%) or partial recovery without dialysis (41.3%), while 10.9% progressed to chronic kidney disease, and 13.0% unfortunately passed away. Fetal survival rate was observed to be 69.6%. Conclusion: Pregnancy related AKI is a serious concern with risks to both mother and fetus. Understanding its causes and improving management are essential for better outcomes. This study offers valuable insights into PRAKI's etiology and outcomes, emphasizing the importance of early intervention.