Assisted reproductive technology was introduced into medical practice with little formal evaluation of its effects on maternal and fetal well-being. Having in mind that the number of pregnancies deriving from assisted reproductive technology (ART) is steadily increasing worldwide, not unreasonably, there is an increasing interest and criticism regarding the potential risks for adverse obstetric and perinatal outcomes after ART. This narrative review aims to offer documented information on this extended issue. The majority of the studies document an incidence of 2–11% for ectopic pregnancy of any location resulting from ART, stating that there is a significant increase in the occurrence of ectopic pregnancy compared to normally conceived pregnancies. Following assisted reproduction treatment, the risk of miscarriage and its incidence are slightly higher, inevitably, after IVF treatment than in spontaneously conceived pregnancies, mainly due to the increased average age of women seeking ART treatment. However, this risk appeared to be similar in age-matched women groups using fresh nondonor eggs. Currently, it is considered rather a complication than a success, the achievement of a multiple pregnancy, the rate of which may be as high as 20–25% of the medically assisted pregnancies. This rate is increased after ART, unfortunately, followed by increased pregnancy complications and adverse pregnancy outcomes. It is obvious that transferring more than one embryo in the uterine cavity, the chances of having higher than singleton order pregnancies, is significantly increasing. It is uncertain whether ICSI compared with natural conception or standard IVF is associated with an increased risk of chromosomal abnormalities (general, autosomal, sex-linked or de novo). The existing level of evidence is of very low quality. Regarding congenital anomalies, the existing evidence indicates that a higher rate has been observed in children after ART, compared to children after natural conception, particularly more frequently after ICSI than IVF, in a similar frequency in singleton and twin pregnancies, as well as after fresh embryo transfer compared to FRET. There is evidence indicating that pregnancies created with ART had a significantly increased risk, of approximately 30% for the development of pregnancy-induced hypertension. On the other hand, the available data indicate that the singleton pregnancies created with ART experienced a significantly increased relative risk of 1.53 for developing gestational diabetes mellitus. However, it is worth noting that the vast majority of the available existing studies indicate that subfertile and in vitro-fertilization-treated women have a higher mean age and therefore have more preexisting chronic conditions, predisposing them to the development of pathologic pregnancy conditions like pregnancy-induced hypertension or gestational diabetes. Given the increased multiple pregnancy rate in IVF/ICSI, it is logical that the overall preterm and very preterm labor rate is higher in medically assisted pregnancies. Furthermore, comparing the rates of preterm deliveries in similar singleton pregnancies, achieved either naturally or after ART, a significantly increased relative risk of 1.71 of developing preterm labor and of 2.12 of developing very preterm labor was found. Taking into account the available data, ART pregnancies also carry a significantly increased risk of 30% of presenting the complication of the premature rupture of the membranes, compared to spontaneously achieved pregnancies. The extreme end amniotic fluid volume, in either side (polyhydramnios or oligohydramnios), is often expected in cases of gestational diabetes or intrauterine growth restriction, conditions commonly met in the ART pregnancies. Therefore, it is not utopic to anticipate amniotic fluid volume aberrations in ART pregnancies. The data for the incidence of IUGR after ART are conflicting, since some studies did, while others did not confirm the above risk. On the other hand, since preterm and very preterm birth were found to be commoner in ART pregnancies, it is obvious that low birth weight (LBW) and very low birth weight (VLBW) are expected natural sequels. Apparently, the available data confirm this statement, deriving from various meta-analyses and other studies, stating a significantly increased relative risk, varying between 1.65 and 2.12 of delivering low birth weight newborns. There is an increased risk of perinatal mortality in IVF/ICSI pregnancies, when compared to spontaneous conceptions, establishing a relative risk varying from 1.64 to 1.87 according to the available literature. The cesarean section rate is also considered to be increased in ART pregnancies, with all the corresponding meta-analyses reporting a significantly higher relative risk from 1.2 to 1.52. Interestingly, placenta-related complications are significantly increased in ART compared to natural conception pregnancies, since the available data suggest that the risk of placenta previa is 3.71–3.76 times common. Placental abruption is also significantly common, demonstrating a pooled Odds Ratio of 1.83–1.87, similarly to the occurrence of morbidly adherent placenta, which is more than twice as common in terms of incidence in ART pregnancies. The underlying mechanisms involved in the association between ART and obstetric risks, leading to these adverse obstetric outcomes in infertile women, remain unclear and require further research, more powerful data in well-designed studies, for further elucidation. It is reasonable and logical that obstetricians should manage these pregnancies carefully, thoroughly, and as potentially high risk. This, in turn, may lead to prompt and effective interventions during early pregnancy, preventing and effectively managing these unpleasant complications.