In Brazil, pregnancy at extreme ages, whether in adolescence or advanced age, poses significant challenges to maternal and neonatal health. In a country where one in every seven babies is born to adolescent mothers, and there has been a 70% increase in pregnancies among women aged 35 to 38 over the last two decades, it becomes essential to understand the obstetric and neonatal repercussions of these pregnancies. This study aimed to analyze the fetal, neonatal, and obstetric complications associated with early and advanced maternal age. It is an epidemiological study with data collected from TabNet of DataSUS, covering the period from 1996 to 2020. The variations found included maternal and fetal deaths, as well as sociodemographic characteristics of the mothers. The results show that adolescent mothers have a higher risk of newborns with low birth weight and fetal mortality, especially in the Northeast region. On the other hand, older mothers show lower fetal mortality but a higher prevalence of obstetric complications, particularly in the Southeast region. The research highlights the need for public policies focused on reducing risks in pregnancies with greater vulnerability and on training health professionals for better monitoring.