Safe, secure, healthy housing is a crucial determinant of health. The aim of this study was to determine whether women that experienced homelessness (WEH) in England prior to or during pregnancy, are at greater risk of adverse pregnancy outcomes than women that are housed. A retrospective nationwide population study was conducted using English national Hospital Episode Statistics Admitted Patient Care database. The population included one randomly selected singleton birth with a gestational age >24 weeks' per women, in hospital, between the 1st January 2013 and 31st March 2023. WEH were identified as having at least one homeless code ("no fixed abode", "registered with a homeless-exclusive GP practice", "clinical diagnosis of homelessness") at the time of birth. Logistic regression was used to estimate the odds ratios of severe maternal morbidity (SMM), preterm birth (<37 weeks') and low birthweight (<2500 g) for WEH compared to housed women overall and those in the most deprived areas. Results were adjusted for age, ethnicity, parity, year of birth and pre-existing medical conditions. The study population comprised 3 349 601 births from 2013–23. 3301 (0·1%) births were from WEH. Homelessness increased the risk of SMM, preterm birth and low birthweight, with fully adjusted odds ratios (aOR) of 1·28 (95% CI 1·02–1·60), 2·02 (95% CI 1·81–2·25) and 2·16 (95% CI 1·94–2·40) respectively compared to housed women. This remained significant when compared to women living in the most deprived areas: aOR 1·24 (95% CI 0·99–1·55), 1·94 (95% CI 1·62–2·34), 1·87 (95% CI 1·69–2·08) respectively. These results highlight the need for prioritisation in policy to improve housing prior to and during pregnancy. Quality research that investigates not just dichotomous homelessness, but the impact of frequent moves during pregnancy, housing quality and overcrowding is required, which necessitates the collection of detailed housing information through pregnancy and the postnatal period. NV is funded by a clinical research fellowship from Nuffield Department of Population Health and Academy of Medical Sciences Starter Grant for Clinical Lecturers. [ABSTRACT FROM AUTHOR]