Factors Influencing Excessive Gestational Weight Gain Among Pregnant Women in Urban Malaysia Introduction Excessive gestational weight gain (GWG) is a growing public health concern due to its association with higher risk of adverse maternal and perinatal outcomes. Recognising the key factors of underlying GWG incidence is thus crucial for developing targeted interventions. This study aims to determine the prevalence of excessive GWG and its associated factors among pregnant women in an urban district of Klang Valley, Malaysia. Methods A retrospective cross-sectional study was conducted (betweenNovember 2017 and October 2018) among 472 pregnant women who gave birth between January 2015 and December 2016. Data on sociodemographic characteristics, medical illnesses, and pre-pregnancy body mass index (BMI) were retrieved from the birth registry and maternal health records. The classification of GWG is based on the Institute of Medicine's recommendation Results The classification of GWG is based on the Institute of Medicine's recommendation. A total of 113 (23.9%) pregnant women had excessive GWG. Multiple logistic regression showed the odds of getting excessive GWG were higher among those with lower education levels (Adj. OR = 1.85; 95% CI = 1.084, 3.147), being employed (Adj. OR = 2.30; 95% CI = 1.342, 3.928), nulliparous (Adj. OR = 2.46; 95% CI = 1.450, 4.164), and having pre-pregnancy BMI of ≥25kg/m2(Adj. OR = 6.47; 95% CI = 3.909, 10.721). Conclusions Lifestyle interventions, such as weight reduction programs and health education, should focus on women with high pre-pregnancy BMI, nulliparous women, working women and women with low education levels. Pre-pregnancy clinics and workplaces can serve as platforms to promote healthy dietary choices and encourage regular physical exercise.