Introduction: In women with heart disease, maternal mortality is reported to be much higher than average and the risk appears to be increasing. In western countries heart disease is the major cause of maternal death. The full spectrum of structural heart disease including congenital heart disease (CHD), valvular heart disease (VHD), and cardiomyopathy (CMP), and also ischemic heart disease (IHD) may be encountered in pregnant women. Aim of the study: The aim of this study was to determine the impact of ischemic heart diseases on maternal adverse outcome during pregnancy. Methods: This was a retrospective cohort study and was conducted in the Department of Gynaecology and Obstetrics of Kushtia General Hospital, Kushtia, Bangladesh during the period from January, 2021 to January, 2022. There was total 100 women in our study. This study was conducted among pregnant women with ischemic heart disease. The study population was categorized into two; namely, Group A -women with IHD(n=50) and Group B - women without IHD (n=50). Result: In total 100 patients from both the groups completed the study. In our study we found the mean ± SD age of pregnant mothers in Group A was (30.01 ± 5.00) and in Group B (27.05 ± 5.04) respectively. The mean± SD of BMI for women in Group A was (27.47 ± 4.40) and in Group B (28.34 ± 5.67) respectively. The prevalence of Hypertension was found in 41(82%) & 21 (42%) and DM was 68% & 36%among Group A & B respectively. Transient Ischemic Attack & Stroke was found 46% & 16 % in Group A respectively. Arrythmia was only found in Group A by 36% & 28%. Conclusion: In our study, we found that the incidence of adverse maternal outcomes was higher among women with IHD. Pregnant women with IHD have a higher risk of maternal and fetal complications compared with women without HD. Cardiomyopathy, hypertension, and arrhythmias were independently associated with higher rates of major adverse maternal events was found in our study.