Trends showed an increase in the proportion of women experiencing adverse pregnancy outcomes in Zimbabwe from 2005 to 2015. Advanced maternal age, marriage, lack of religion and living in Harare, Mashonaland Central or Mashonaland West were associated with adverse pregnancy outcomes. There is a need to reduce these outcomes through integration of social issues into maternal health programmes, as well as ensuring accessibility and availability of comprehensive reproductive health services that target high-risk groups such as women aged 35 - 49 years.