Abstract Background Obstetric morbidity encompasses health issues related to pregnancy or childbirth, excluding accidental causes. The whole process of childbearing is not just a biological phenomenon, rather it is governed by personal, social, cultural, and institutional factors. The entire eastern region of India including the four provinces of Bihar, Jharkhand, Odisha, and West Bengal is susceptible to high maternal mortality and morbidity. It presents a strong background to further envisage the factors responsible for such situation. Thus, the study aims to explore regional variations and socio-economic factors associated with obstetric morbidity among women in eastern India. Methods This study uses data from the 2019-2021 National Family and Health Survey (NFHS 5). The explanatory variable, obstetric morbidity, includes issues during pregnancy and delivery- vision difficulties, bleeding, swelling, convulsions, fever, breech presentation, and prolonged labor. Predictor variables include age, age at marriage and first birth, wealth index, residence, toilet facility, caste, working status, media exposure, religion, birth order, and education level. Bivariate and binary logistic regression analyses have been used as a methodological tool. Results In the eastern region, 53.76% women experience obstetric issues. Women belonging to 15-24 years with higher educational attainment increases the prevalence of obstetric morbidity. The probable reason is, with education, awareness about reproductive morbidity increases and in turn the reporting for morbidity increases. Therefore, the findings showed age, educational attainment, wealth quintile, media exposure, residence, work status, birth order and toilet facilities are highly associated with obstetric morbidity among women. Conclusions Implementing of targeted interventions, and awareness campaigns are crucial to reducing obstetric complications and maternal mortality in the eastern region of India Key messages • Socioeconomic correlates impact obstetric morbidity in eastern India in manifolds especially education, age, and wealth quintile of women in eastern India. • Obstetric morbidity is a growing concern in eastern India, thus implementing targeted interventions and awareness campaigns are much needed.