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Over the last two decades, obesity and overweight have increased significantly, becoming public health problems worldwide. Data from literature show a continuous increase in the prevalence of the two entities, which results in an increasing number of overweight or obese patients who reach the reproductive age and become pregnant. Pregnancies in obese or overweight patient are the new challenges that obstetricians have to face. This review is based on publications that were found on PubMed, with a special attention to the review articles, cohort studies and randomized trials. Obesity and overweight can affect both getting and maintaining a pregnancy. The chances of obtaining a pregnancy decrease linearly by 4% for every 1 kg/m² gained, starting from a Body Mass Index (BMI) of 29 kg/m². The prevalence of fetal malformations is also increased in overweight or obese patients, the risk raising proportionally with the severity of obesity. These endemic diseases are also associated with certain maternal complications. A 10% increase in weight during pregnancy compared to pregestational BMI has been shown to be a factor that increases the risk by about 10% for the occurrence of hypertension and gestational diabetes, respectively. Newborns are also affected by these pathologies. Newborns in obese mothers have an increased percentage of adipose tissue, and studies have shown that there is an association between maternal adiposity and fetal weight at birth. The interventions in lifestyle and nutrition during pregnancy did not have an important effect on reducing the incidence of maternal and fetal complications. Therapeutic strategies are needed for normalizing body weight before pregnancy because reducing BMI has benefits for both mother and fetus. [ABSTRACT FROM AUTHOR]