Pregnancies at advanced maternal age (AMA), that is, childbearing in women over a certain age does not have an accepted threshold in literature. In general, however, studies consider maternal age over 40 as pregnancy at AMA. Lack of a clear-cut description makes it impossible to conclude a definite figure on its incidence. Industrialized countries with higher income levels accommodate AMA pregnancies more frequently. Such pregnancies come with various complications. During the early weeks of gestation, patients are posed with the risk of ectopic pregnancy and an increased risk of aneuploidy as well as an elevated risk of spontaneous abortion due to deteriorated egg quality and alterations in uterine and hormonal functions. Risk of congenital malformations also raises with AMA. The most common congenital malformations are cardiac malformations. Maternal morbidity and mortality increase due to the risk of chronic medical diseases accompanying the age of pregnant women. AMA also brings along higher incidences of amnion fluid embolism, obstetric shock, renal failure, and hospitalization at the intensive care unit. In such pregnancies, the most common concomitant disorders are hypertension and diabetes mellitus which are particularly prevalent in overweight and obese women. AMA is an independent risk factor for placenta previa. Major causes of perinatal morbidity in pregnancies at AMA are preterm delivery and low birth weight. Risk of stillbirth is increased by 65% in women above the age of 35 compared to the younger group, and most of fetal death arise after 37 weeks of gestation. Therefore, such pregnant women are instructed to count fetal movements and attending obstetricians are recommended to evaluate biophysical profile and to offer elective induction of labor after week 39. Pregnant women above the age of 35 experience dystocia and Cesarean section more frequently. Following the preterm deliveries born by women at AMA, prognosis of infants was found to be better than infants born to younger mothers, on contrary to expectations. The rate of postpartum maternal mortality also increases with AMA which is attributed to the comorbid disorders.