Background <p>Amniocentesis is a commonly used invasive diagnostic procedure in prenatal care. Although it has historically been associated with a notable risk of pregnancy loss, advances in ultrasound technology and procedural techniques have significantly improved its safety profile. Understanding current complication rates and related risk factors is essential to support evidence-based patient counseling and informed decision-making.</p> Methods <p>We conducted a retrospective cohort study of 1,655 pregnant women who underwent mid-trimester amniocentesis between 2018 and 2023 at a tertiary perinatal referral center. Only singleton pregnancies with normal cytogenetic and anatomical findings were included in the final analysis (<i>n</i> = 917). Data on maternal characteristics, inflammatory markers, and procedural details were collected. Post-procedural complications occurring within 14 days were categorized as mild (e.g., transient abdominal pain, spotting, amniotic fluid leakage) or severe (pregnancy loss). Statistical analysis included descriptive methods and logistic regression to evaluate potential risk factors.</p> Results <p>Among the 917 patients included in the analysis, 63 experienced complications, resulting in a total complication rate of 6.87%. The majority of adverse events were classified as mild and self-limiting. Pregnancy loss occurred in four cases (0.43%) within 14 days of the procedure. No statistically significant associations were observed between complications and maternal age, gestational age at the time of the procedure, body mass index, route of amniotic access, inflammatory markers, or the use of prophylactic antibiotics.</p> Conclusions <p>Amniocentesis appears to be a safe diagnostic procedure when performed by experienced clinicians in a tertiary care setting. The low rate of severe complications reinforces its role as a dependable tool in prenatal diagnostics. These findings may help reduce patient anxiety and inform risk communication during prenatal counseling.</p>