Accepted Article | This is not yet the definitive version of record, it is to give early visibility of the article | An open access article published ahead of print under the CC BY license (https://creativecommons.org/licenses/by/4.0/) | DOI and Page numbers will be assigned to the final version before inclusion into the next issue     Background: Pregnancy is a physiological process and should ideally yield no morbidity and mortality; however, in some instances, pregnancy becomes a high-risk. A high-risk pregnancy carries significant danger to the fetus and mother before, during and after delivery. The objective of the study was to determine the perinatal outcome among women with high-risk pregnancies. Methodology: This cross-sectional study was conducted from June to December 2015, including 287 women with high-risk pregnancies scheduled to undergo delivery at Liaquat University Hospital in Karachi, Pakistan. Data pertaining to sociodemographic details, gestational, obstetric history, Apgar score and the perinatal outcome was recorded using a pre-structured questionnaire and analyzed using SPSS version 16.0.. Results: The mean age of the enrolled participants was 29.12 ± 5.46 years. The perinatal outcomes included stillbirths (8%), early neonatal deaths (4.2%), low birth weight (22.6%) and poor Apgar score i.e., < 7 at 1 minute (10.5%) and 5 minutes (3.8%). Stratification revealed a significant risk of poor perinatal outcome (low birth weight) among women aged above 30 years (p-value = 0.002). Conclusion: It is concluded from the study results that high-risk pregnancies yield poor perinatal outcomes, including stillbirths, low birth weight, early neonatal death and poor Apgar scores.