PROBLEM: According to systematic literature reviews, most studies measured pregnant women's quality of life using generic measures. BACKGROUND: Condition-specific questionnaires are more sensitive and responsive than generic questionnaires. There is a great need to establish specific measures for assessing pregnant women's health-related quality of life considering their unique experiences of pregnancy. AIM: To develop and test psychometric properties of the PregQOL, a health-related quality of life measure specific to pregnant women. METHODS: To construct the items of the PregQOL, we conducted semi-structured face-to-face interviews with five pregnant women in addition to an extensive literature review. For psychometric testing, data were collected with a convenience sample of 411 pregnant women. Construct validity was assessed via exploratory and confirmatory factor analyses. Convergent and known-groups validity were evaluated. Internal consistency reliability was studied using Cronbach's alpha and McDonald's omega. Test-retest reliability was examined. FINDINGS: After evaluation of content validity and exploratory/confirmatory factor analysis, the 24-item PregQOL was developed with four dimensions: daily functioning, supportive conditions, adaptation to pregnancy, and psychological well-being. It demonstrated convergent validity with relations to a quality of life measure for general population. Known-groups validity was supported by significant differences between the depressed and non-depressed groups. The scale demonstrated adequate internal consistency and test-retest reliability. It also showed good reliability across three trimesters of pregnancy. DISCUSSION: The newly developed PregQOL demonstrated good psychometric properties across three trimesters of pregnancy. CONCLUSION: The PregQOL might be useful for helping midwives and other healthcare providers understand the overall well-being of pregnant women.