Obesity affects one third of reproductive age women, of whom 22% are affected by class III Obesity. We sought to determine differences in maternal pregnancy outcomes associated with maternal super obesity (Body Mass Index [BMI] ≥50), super-super obesity (BMI ≥60) by race/ethnicity. We conducted a retrospective cohort study of 50,051 women with singleton, vertex, non-anomalous gestations and BMI ≥50, then examined rates of cesarean delivery, gestational hypertension, gestational diabetes, preterm birth, macrosomia, and Apgar score by race/ethnicity. Pre-pregnancy BMI was dichotomized (super obese and super-super obese). Multivariate regression analyses and chi-square tests were employed for statistical comparisons and a p-value of less than 0.05 was used to indicate statistical significance. Super-super obesity was associated with a statistically significant increase in all investigated outcomes in each ethnic group. AOWhen compared with super-super obese White women, significantly lower rates of cesarean delivery were noted in super-super obese Hispanic women (OR, 0.78; 95% CI, 0.63-0.91) and Asian women (OR, 0.20; 95% CI, 0.06-0.63). Gestational diabetes (OR, 0.66; 95% CI, 0.52-0.84) and macrosomia (OR, 0.55; 95% CI, 0.34-0.87) were found to be significantly lower in Black women. Higher rates of preterm birth were found in super-super obese Black women (OR, 1.30; 95% CI, 1.00-1.69) and Hispanic women (OR, 1.43; 95%CI, 1.03-2.0). Overall, increasing levels of super obesity are associated with higher rates of pregnancy complications than women with lower levels of obesity. Interestingly, the effect of super obesity on pregnancy varies by race, possibly explicated by physiologic variation by race in adapting to metabolic changes. Further investigation of pregnancy outcomes and race in the setting of obesity is needed in order to optimize the short and long-term care and counseling for these women.