Introduction: Offsprings exposed to intrauterine hyperglycaemia are at increased risk of obesity, type 2 diabetes in postnatal life. Little is known about gestational diabetes in KONKAN region of Maharashtra where women are undernourished across all stages of life. We estimated the prevalence of gestational diabetes among pregnant women visiting tertiary care hospital in KONKAN region. Methods: Between March 2020 and November 2020, 514 pregnant women registered in the antenatal clinic of BKL Walawalkar Hospital in KONKAN region. They underwent oral glucose tolerance test using the protocol set by Maternal & Child Health Division of Government of India. Results: Five hundred and six women completed oral glucose tolerance test. Mean age, gestation, weight and BMI at registration were 26.7 years, 23.1 weeks, 48.3 kg and 20.5 kg/m2 respectively. Prevalence of GDM was 20.3% and more than 50% of them were diagnosed before 24 weeks of gestation. Conclusion: Our results have shown that presence of GDM despite absence of overweight (high BMI). This is the first demonstration of hyperglycemia in pregnancy among undernourished women of KOKAN region. Offspring’s exposed to intrauterine hyperglycemia are at increased risk of obesity, type 2 diabetes in postnatal life hence long term implication of GDM in KONKAN can only be understood by systematic, community based study. Keywords: GDM; Rural; KONKAN; India; Malnutrition; Insulin resistance