Background: Dengue fever, a mosquito-borne viral infection, is a growing concern for maternal and fetal health in endemic regions, particularly in South Asia. Dengue infection during pregnancy poses serious risks, yet comprehensive data on its impact remains limited. Objective: This study aims to evaluate the maternal, fetal, and neonatal outcomes associated with dengue infection in pregnant women based on evidence from ten South Asian studies. Methods: A systematic analysis was conducted across ten studies involving 1,956 pregnant women with confirmed dengue infection through NS1 antigen and/or IgM antibody testing. The pooled prevalence of maternal and neonatal complications was calculated, with statistical significance determined at a p-value of <0.05. Results: Postpartum hemorrhage was the most prevalent maternal complication, affecting 3.02% of cases. Additionally, 1.02% of infected women required ICU admission, and the maternal mortality rate was 0.51%. Other maternal complications included hypertensive disorders (0.46%), acute kidney injury (0.41%), and acute respiratory distress syndrome (0.36%). Fetal and neonatal complications were also notable, with preterm birth occurring in 3.63% of cases, low birth weight in 2.76%, and NICU/SNCU admission in 2.15%. Adverse outcomes, such as stillbirth/intrauterine death (1.02%) and miscarriage (0.72%), were also observed, with 0.61% of cases showing evidence of vertical transmission. Conclusion: Dengue infection during pregnancy is associated with significant maternal and fetal/neonatal risks, including postpartum hemorrhage, preterm birth, and pregnancy loss. This analysis underscores the need for vigilant monitoring, early diagnosis, and intervention in pregnant women with dengue to improve outcomes.