Background <p>Nutrition during pregnancy plays a pivotal role in fetal growth, preserving the mother’s health, and fostering long-term health for both mother and child. This study aims to explore the dietary patterns, nutritional risks at conception and prescribed diet interventions in prenatal condition among pregnant women.</p> Methods <p>Current retrospective study was carried on 3294 pregnant women, who presented to nutrition clinic with comprehensive nutritional assessments and dietary prescriptions at a tertiary care center for a five-year period.</p> Results <p>Overall mean age of pregnant women was 27.3 ± 3.9&#xa0;years. At presentation to nutrition outpatient clinic, only 26% (<i>n</i> = 856) of pregnant women had normal weight and 5% (<i>n</i> = 164) were underweight. Most of them had a BMI of more than 25&#xa0;kg/m2 (39%-overweight, 22%-obese, 8%-morbidly obese). Based on modified Malnutrition Universal Screening Tool ((BAPEN- British Association for Parenteral and Enteral Nutrition) -MUST), 52% pregnant women were classified as low nutritional risk and 48% as high nutritional risk. Dietary assessments revealed a predominant preference for non-vegetarian diets, with 45% of pregnant women reporting high-fat intake, and 32% and 23% consuming high-sugar and high-salt foods, respectively. Safflower and sunflower oils, rich in polyunsaturated fatty acids (PUFA), were used by 74% (<i>n</i> = 2432) of mothers. Eighty percent of mothers reported sedentary behavior. Most of this cohort referred to nutritionists had gestational diabetes mellitus and/or high BMI (54%) and anemia (4%). Dietary interventions predominantly focused on low glycemic index diets with essential fats and protein for 54% (<i>n</i> = 1778) mothers targeted at optimal weight gain as per pregnancy BMI.</p> Conclusion <p>Early nutritional screening in antenatal care enables timely identification of nutritional deficits for targeted dietary and lifestyle interventions, contributing to optimal maternal and fetal outcomes.</p>