This study aimed to develop and examine the validity and reliability of a pregnancy symptoms questionnaire. A total of 214 pregnant women aged 19 to 40 years old were purposive randomly recruited from December 2009 to January 2010 in Antenatal Clinic, Hospital Universiti Sains Malaysia. Pregnant mothers at second and third trimesters were interviewed to complete the Pregnancy Symptoms Questionnaire (PSQ). The PSQ was developed by experts in nutrition, obstetrics and statistics. The PSQ consists of 38 items on frequency and severity of pregnancy symptoms. Factor analysis was done using Promax rotation method to check for construct validity. A total of 16 items which had poor correlation (<0.3) and less important content were removed during the final revise. The 22 remaining items were found to be loaded on the three components (general, constitutional and somatic pain). The overall Cronbach’s alpha coefficient was 0.93 and for each three components ranges from 0.70–0.87. The results suggest that the final PSQ consisting of 22 items is valid and reliable for measuring the frequency and severity of the symptoms experienced during pregnancy. It can be used in nutritional studies related to pregnancy and its outcome.