Purpose <p>The main purpose of this review is to examine the outcomes of pregnancy following different metabolic and bariatric surgical procedures.</p> Methods <p>A comprehensive literature search was conducted in PubMed for studies published between 2014 and 2024, focusing on pregnancy outcomes after bariatric surgery. The review analyzed outcomes across different surgical procedures: Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), adjustable gastric banding (AGB), and biliopancreatic diversion with duodenal switch (BPD-DS).</p> Results <p>Metabolic and bariatric surgery demonstrates significant benefits in reducing obesity-related pregnancy complications, including decreased rates of gestational diabetes and hypertensive disorders. However, procedure-specific risks were identified: RYGB showed increased risks of internal herniation and nutritional deficiencies; SG demonstrated more stable glycemic profiles with lower rates of complications; AGB required ongoing adjustment during pregnancy; and BPD-DS presented the highest risk of nutritional deficiencies. Small-for-gestational-age births were more common after malabsorptive procedures compared to restrictive ones. The traditional recommendation of waiting 12–24&#xa0;months before conception appears oversimplified, with evidence suggesting procedure-specific timing considerations may be more appropriate.</p> Conclusions <p>While all bariatric procedures improve pregnancy outcomes compared to untreated obesity, the choice of procedure for women of reproductive age should carefully consider the balance between metabolic benefits and potential risks to maternal and fetal health. Individualized, procedure-specific approaches to post-surgical care and pregnancy timing are recommended.</p>