Purpose: To explore the association of maternal periodontitis with preterm delivery and low birth weight in the state of Karnataka, India. Materials and Methods: A prospective study was conducted among 340 pregnant women between 18 and 28 years of age. Subjects filled out a questionnaire and underwent a periodontal examination during the second trimester of pregnancy. The questionnaire included details regarding socioeconomic status, passive exposure to cigarette smoking, medical and reproductive history. Periodontal examination was performed according to the community periodontal index and clinical attachment loss. Logistic regression analyses were used to assess the association of periodontitis with pregnancy outcomes. Results: Of 340 subjects enrolled in the study, 33 (9.71%) were either excluded or not available for follow-up. Of the remaining 307 subjects, 126 (41.04%) had periodontitis. Among subjects with periodontitis, 15.87% had a preterm birth (PTB) and 34.25% had low birth weight (LBW) infants. In the periodontally healthy group, the rates of PTB and LBW deliveries were 9.39% and 18.78%, respectively. Logistic regression analysis showed a strong association between periodontitis and poor pregnancy outcomes after adjusting for all variables with OR 4.54 (95% CI = 1.98-5.46) for PTB, and 5.32 (95% CI = 2.01-6.79) for LBW. Conclusion: The results suggest that periodontitis is an independent risk factor for poor pregnancy outcome. Keywords: low birth weight, periodontitis, pregnancy, pregnancy outcomes, preterm birth