Intimate partner violence (IPV) in pregnancy poses serious threats to maternal and neonatal health. Primary studies from Egypt report widely divergent prevalence estimates and heterogeneous methods, hindering clear policy and clinical guidance. We followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 and Cochrane guidelines. We searched multiple bibliographic and gray-literature sources for observational studies (2005–2025) reporting IPV during pregnancy in Egypt. Fourteen studies (n ≈ 19,471) met inclusion criteria. The pooled prevalence of any IPV during pregnancy was 47% (95% CI [39, 54]; I2 ≈ 99%). By subtype, pooled prevalence was: emotional/psychological 42% ( [29, 56]), physical 27% ([21, 34]), and sexual 12% ([8, 18]). Consistent risk factors included husband substance use (pooled odds ratio [OR] 7.75; [3.90, 15.41]), marital/relationship problems (OR 9.43; [4.66, 19.07]), husband controlling behaviors (OR 6.67; [2.89, 15.40]), having children (OR 2.22; [1.52, 3.23]), younger maternal age <30 years (OR 2.14; [1.57, 2.90]), low wife education (OR 1.45; [1.31, 1.60]), and household economic problems (OR 1.79; [1.35, 2.38]). IPV exposure was associated with several adverse pregnancy outcomes, notably premature rupture of membranes (OR 4.09; [2.49, 6.72]), induced abortion (OR 4.25; [2.61, 6.93]), preterm labor (OR 2.60; [1.81, 3.75]), stillbirth (OR 2.53; [1.34, 4.78]), low birth weight (OR 3.21; [1.37, 7.52]), neonatal death (OR 2.42; [1.35, 4.32]), and maternal depression (OR 1.82; [1.31, 2.53]). In Egypt, approximately one in every two women experiences IPV during pregnancy. IPV is associated with substantial maternal and neonatal morbidity and mortality. Findings support integrating culturally appropriate IPV screening and referral into antenatal care, community-level prevention, and priority for harmonized, prospective research to refine national estimates and evaluate interventions.
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