Introduction <p>Pharmacist-led interventions are crucial for improving healthcare outcomes, particularly for pregnant women who face unique medication-related risks. Effective medication management during pregnancy directly impacts maternal and neonatal health, reducing medication errors and adverse drug reactions due to physiological changes and the need to avoid teratogenic substances. This review aimed to systematically evaluate the impact of pharmacist-led interventions on medication adherence, clinical outcomes, and maternal or neonatal health among pregnant women.</p> Methods <p>Following PRISMA guidelines, a comprehensive search of PubMed, Embase, and Scopus was conducted to identify studies from 2013 to 2023 on pharmacist-led interventions in pregnant women. Randomized controlled trials, quasi-experimental studies, and observational studies were included. Data were extracted using a standardized form, and study quality was assessed with Cochrane ROB 2, ROBINS-I, and modified Newcastle-Ottawa Scale.</p> Results <p>Seven studies from Canada, Australia, Indonesia, Norway, Nigeria, and China were included. Pharmacist interventions, such as medication therapy management, patient education, and the identification of drug interactions, significantly improved medication adherence, clinical outcomes, and patient satisfaction. These interventions were particularly effective in managing hypertensive disorders, asthma, and gestational diabetes mellitus, leading to better health outcomes and fewer adverse events.</p> Conclusion <p>Pharmacist-led interventions significantly improve health outcomes for pregnant women by enhancing medication adherence and clinical care. Further research is needed to confirm these benefits, standardize outcomes, and explore additional areas of impact to optimize maternal and neonatal health.</p>