INTRODUCTION: To investigate the maternal and fetal outcomes of pregnant patients who were involved in a motor vehicle accident (MVA). MATERIALS AND METHODS: This retrospective, single-center study was conducted at a tertiary care center. A total of 66 patients who experienced an MVA between November 2019 and February 2024 were included. The patients were divided into three groups based on the trimester during which the MVA occurred. Additionally, the patients were categorized into two groups according to whether they were wearing a seatbelt at the time of the MVA. The maternal and fetal outcomes of the patients were analyzed. RESULTS: The duration of hospitalization was longer among the patients in the third trimester during the MVA compared to the remaining trimester groups (P = 0.023). The same group also had significantly higher rates of placental abruption (P = 0.002) and blood transfusion (P <
0.001). The patients who were in the first trimester at the time of an MVA had a higher rate of abrasion (P = 0.004). The fifth-minute Apgar score was lower in the group not using a seatbelt (P = 0.035). The preterm birth rate was statistically significantly higher in the group not using seatbelts (P = 0.012). The rates of placental abruption and transfusion were also higher in the group not using seatbelts (P <
0.001). CONCLUSIONS: Pregnant patients foregoing seatbelt use for any reason may face significant maternal-fetal morbidity and mortality risks during an MVA. We also observed that as gestational age advanced in pregnant patients experiencing MVA, maternal-fetal morbidity and mortality increased.