Overweight and obesity constitute a major health concern for both mothers and their developing children. Despite efforts in health care services the prevalence of maternal obesity is high and rising worldwide. Health care professionals, e.g. obstetric, pediatric and anesthesia personnel are faced with the challenge of surveillance of obese gravida. Due to the lack of current guidelines for the management of obesity in pregnancy with respect to increased fetomaternal morbidity and mortality, this review aims to discuss relevant obstetric issues caused by a higher maternal body-mass index (BMI).