Objective To find out the frequency and pattern of physiological skin changes in pregnant women. Methods This descriptive study evaluated 200 consecutive pregnant females presenting to Dermatology Outpatient Department of Nawaz Social Security Hospital, Lahore over a period of one year. Results Total of twenty-three cutaneous manifestations were studied including striae gravidarum, hyperpigmentation, hair, nail and vascular changes. Majority of pregnant females complained of striae gravidarum (stretch marks) affecting 71.5% of study population closely followed by pigmentation i.e. linea nigra (64.5%) and melasma (63.5%). The most common vascular change noticed was palmar erythema (43.5%) and nail changes included leukonychia (15%), while diffuse hair loss (11.5%) was the most frequently found hair change. Conclusion The appreciation of common physiological skin changes during pregnancy will assist in better patient care during antenatal period.