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Objectives The objective of this study was to describe the occurrence of lifetime trauma exposure in relation to perinatal health outcomes in low-income African American women. Methods One hundred and sixteen pregnant African American women recruited from two public prenatal clinics participated in this exploratory study. Information was obtained about psychological symptoms, medical conditions, prenatal care utilization, and health behaviors. To measure lifetime trauma exposure, women completed the Trauma History Questionnaire. Maternal and infant outcome data were obtained from the medical records following delivery. Results The occurrence of trauma exposure was high, with 87% of the women reporting at least one traumatic event. Their mean age was 25 years, 21% were primiparas, and they reported a mean of 4.3 ± 3.5 (median = 3) traumatic events during their lifetime. Crime-related experiences were common and included incidents of family or friends being murdered or killed (40%), robberies (23%), home burglaries (14%), attacks with weapons (13%), and muggings (12%). Lifetime trauma exposure was significantly associated with depressive symptoms, anxiety, and generalized stress. Women with greater lifetime trauma exposure had a higher rate of tobacco use, higher rate of premature rupture of membranes, and longer maternal hospital stay. Conclusion Low-income African American women in this sample experienced a variety of traumatic events. Lifetime trauma exposure was associated with adverse perinatal health. Findings suggest the need to further investigate trauma across the lifespan to better understand the impact of these experiences on the reproductive health and well-being of women and their infants.