Millions of people suffer from iron deficiency which can lead to anemia annually. Most of those population are low income, and poor diet intake which leads to health and function implications. Interestingly, woman and particularly pregnant female are increase their demand for iron supplement to avoid the serious health consequences on their body and fetus. The iron deficiency and anemia have a great risk on pregnant women and fetus heath which can induce many health defects during perinatal period. On the other hand, the excessive iron level in the mother body can lead to Fenton reaction and generation of free radical which can damage fetus tissue specially in brain, liver and kidney. Therefore, adjusting iron dose and level during pregnancy are a crucial medical intervention to avoid multi organ damage either by deficiency or excessive intake of iron. In this review, iron metabolism and its effect on mother and fetus health will be discussed with the appropriate intervention to control the low and high level of iron during pregnancy.