This systematic review and meta-analysis aimed to estimate the prevalence of maternal anxiety during the antenatal and postnatal periods. The study included 102 studies involving 221,974 women from 34 countries. The prevalence of self-reported anxiety symptoms was 18.2% in the first trimester, 19.1% in the second, and 24.6% in the third. Overall, the prevalence of self-reported anxiety symptoms across all trimesters was 22.9%. For clinical diagnoses, the prevalence of any anxiety disorder was 15.2%, and for generalised anxiety disorder, it was 4.1%. Postnatally, the prevalence of anxiety symptoms was 15.0% overall, with 9.9% for any anxiety disorder and 5.7% for generalised anxiety disorder. Rates were higher in low- to middle-income countries. Maternal anxiety is a significant public health issue, negatively affecting both maternal and child outcomes. It is associated with increased childbirth fear, preference for Caesarean section, decreased coping strategies, higher rates of eating disorders, and increased suicide risk. It also has important neonatal implications, including increased preterm birth rates, lower Apgar scores, and decreased birth length. Antenatal anxiety is a risk factor for poor child developmental trajectories. Postnatal anxiety is associated with negative and disengaged parenting and overcontrolling maternal behaviors. The study found that maternal anxiety is highly prevalent and requires clinical attention. Research is needed to develop evidence-based interventions. The results suggest that anxiety is a common mental health problem among pregnant and postpartum women, with higher rates in this population than in the general adult population. The study highlights the need for early identification and treatment of maternal anxiety across the perinatal period. The findings also indicate that cultural influences may contribute to higher prevalence rates in low- to middle-income countries. The study underscores the importance of addressing maternal anxiety to improve perinatal mental health and child outcomes.This systematic review and meta-analysis aimed to estimate the prevalence of maternal anxiety during the antenatal and postnatal periods. The study included 102 studies involving 221,974 women from 34 countries. The prevalence of self-reported anxiety symptoms was 18.2% in the first trimester, 19.1% in the second, and 24.6% in the third. Overall, the prevalence of self-reported anxiety symptoms across all trimesters was 22.9%. For clinical diagnoses, the prevalence of any anxiety disorder was 15.2%, and for generalised anxiety disorder, it was 4.1%. Postnatally, the prevalence of anxiety symptoms was 15.0% overall, with 9.9% for any anxiety disorder and 5.7% for generalised anxiety disorder. Rates were higher in low- to middle-income countries. Maternal anxiety is a significant public health issue, negatively affecting both maternal and child outcomes. It is associated with increased childbirth fear, preference for Caesarean section, decreased coping strategies, higher rates of eating disorders, and increased suicide risk. It also has important neonatal implications, including increased preterm birth rates, lower Apgar scores, and decreased birth length. Antenatal anxiety is a risk factor for poor child developmental trajectories. Postnatal anxiety is associated with negative and disengaged parenting and overcontrolling maternal behaviors. The study found that maternal anxiety is highly prevalent and requires clinical attention. Research is needed to develop evidence-based interventions. The results suggest that anxiety is a common mental health problem among pregnant and postpartum women, with higher rates in this population than in the general adult population. The study highlights the need for early identification and treatment of maternal anxiety across the perinatal period. The findings also indicate that cultural influences may contribute to higher prevalence rates in low- to middle-income countries. The study underscores the importance of addressing maternal anxiety to improve perinatal mental health and child outcomes.