Aim: To determine the changes in intraocular pressure and refractive status amongst pregnant women attending Antenatal Clinic in Federal Medical Centre Owerri. Materials/Methods: The study design was a hospital based longitudinal study. Forty six (46) healthy pregnant women were recruited from the ante-natal clinic (ANC) of Federal Medical Centre (FMC) Owerri and followed up from the first trimester of pregnancy to 6 weeks post partum. The same numbers of age matched healthy non pregnant women were also recruited for the study. In line with the Helsinki’s declaration, informed consent and ethical clearance were obtained from all participants and the institutional review board of FMC Owerri respectively. All participants underwent ocular examinations, IOP measurement using Perkins handheld applanation tonometer and retinoscopy (subjective and objective). For the pregnant women, these examinations were repeated and recorded during the second trimester, third trimester and six weeks post partum follow up visits. Data obtained was entered and analyzed using the Statistical Package for Social Science (SPSS) version 21. P value < 0.05 was considered statistically significant. Results: There was a consistent decrease in the intraocular pressure throughout the three trimesters of pregnancy with the lowest fall in the third trimester of pregnancy. This change in intraocular pressure occurring in pregnancy was statistically significant (p ≤ 0.001). In the post partum period, there was a gradual rise in the intraocular pressure towards the first trimester level. A myopic shift in the mean refraction of the pregnant women as the pregnancy advanced was observed. This change in the refractive state was however not statistically significant (p= 0.14) and it did not have any significant effect on their distance visual acuity (p ≥ 0.11) and near visual acuity (p ≥0.10). Conclusion: Normal pregnancy is associated with changes in refractive status and intraocular pressure; nonetheless, these changes are innocuous and gradually resolve following delivery. Therefore, Clinicians may need to delay spectacle correction for pregnant women who experience visual symptoms from physiological changes in refraction unless it is absolutely necessary.