Background: : Maternal and perinatal mortality remain major concern in Laos and many other low- and lower-middle income countries. Standard antenatal screening for of high-risk pregnancies can improve maternal and perinatal health outcomes. Objectives: : to explore the barrier and limitation s of implementing early detection of high-risk pregnancy in Laos. Methodology: : This study took place in four provincial hospitals in Laos from February to December 2023. Qualitative research methods, including key informant interviews at ANC clinics, were conducted Purposive sampling was used to recruit 13 obstetricians, 5 midwives, and 1 general practitioner for data collection. In-depth semi-structured individual interviews were conducted to collect the data, and deductive conventional content analysis was performed concurrently. Results: : Three main themes related to the implementation of antenatal high-risk pregnancy screening were identified: a) The importance of antenatal high-risk pregnancies screening, such as the benefits of early detection, b) barriers to antenatal high-risk pregnancy screening, including political commitment, infrastructure (laboratory testing, drug and medical equipment), cultural beliefs and language barriers, human resources, training issues (availability of antenatal care guidelines, refresher training), and health insurance issues. c) Referral of high-risk pregnancy women, consisting of the need for referral guidelines and improvement of the referral mechanism. Conclusion: Antenatal screening for high-risk pregnancy in Laos is not fully implemented in the four facilities. Human resource capacity, infrastructure, and health insurance coverage need to be improved.