Objective: To determine the maternal and fetal outcome of grandmultiparity in King Abdul-Aziz Medical City Method: This is a descriptive prospective cross-sectional study was carried out in King Abdul-Aziz Medical City in the period from June-Dec 2016.. Study population was all grand multipara admitted for delivery and managed in the labour room in King Abdul-Aziz Medical City. Data was collected using a coded direct interview questionnaire. Most of women were reviewed by me. Data was analyzed by computer using statistical package for social science (SPSS) software version 16 and the results were expressed in tables and figures consent was obtained. Result: Total number of grandmultipara women included in this prospective review was 400. Regarding the maternal outcome we found that those who discharged well were 366 (91.5 %), severe morbidity 33 (8.25 %) and unfortunately 1 (0.25 %) maternal death. Those who developed complications were 124/400 (31 %). These were abnormal fetal presentation 30 (7.5 %), postpartum haemorrhage 28 (7 %), long hospital stay 22 (5.5 %), labour dystocia 20 (5 %), antepartum haemorrhage 8 (2 %), uterine rupture 8 (2 %), precipitated delivery 5 (1.2 %) and others 3 (0.8 %). Regarding fetal outcome who discharged well 370 (92.5 %), fetal death 22 (5.5 %), congenital malformation 6 (1.5 %) and severe morbidity were 2 (0.5 %). Total delivery with fetal complications was 59/400 (13.8 %). Grand multiparas were significantly associated with chronic hypertension (p 0.002), diabetes mellitus (p 0.05), anaemia (p 0.001) and gestational diabetes (p 0.005). No statistically significant associations were found in pre-eclampsia (p 0.04) and renal diseases (0.30) Conclusion: We concluded that women with high birth order are at increased risk for adverse obstetric outcomes (maternal and fetal). The risk is higher for great grand multiparous women compared to grand multiparous women.