Background & aim: Endometriosis is a common gynecological disorder with a partially immune-mediated pathophysiology that remains poorly understood. Although it has been linked to infertility, its association with obstetric complications is less clearly defined, despite overlapping pathophysiological mechanisms with several such complications. This meta-analysis was conducted to determine whether the association between endometriosis and obstetric complications is statistically significant and consistent among previous reports. Methods: A comprehensive search of PubMed, Scopus, Web of Science, EMBASE, and other sources of gray literature was conducted to identify studies published before December 2024. Observational studies that documented the occurrence of specific pregnancy-related outcomes in women with endometriosis compared to those without the condition were considered eligible and included in the review. Results: A significantly increased risks of preterm birth (odds ratio:1.73, 95% CI: 1.42-2.11), placenta previa (3.13, 1.5-6.23), small-for-gestational-age (SGA) infants (1.28, 1.13-1.47), and cesarean delivery rate (1.58, 1.29-1.79), and miscarriage rate (1.85, 1.3-2.47) have been observed in women with prior endometriosis diagnosis. No substantial differences were detected regarding gestational hypertension or pre-eclampsia. High heterogeneity was noted across studies for all outcomes except pre-eclampsia, but the overall risk was determined to be low. Conclusion: Significant pregnancy and birth complications including preterm birth, placenta previa, SGA infants, cesarean delivery, and miscarriage were linked to endometriosis. Pregnant women with prior history of endometriosis should receive specialized care.