The objective of this study was to estimate the associations between gestational weight gain during pregnancy and neonatal outcomes in low- and middle-income countries, with a conclusion that inadequate and excessive gestational weigh gain are associated with a higher risk of adverse neonatal outcomes across settings. Interventions to promote optimal GWG during pregnancy are likely to reduce the burden of adverse neonatal outcomes, however further research is needed to assess optimal ranges of GWG based on data from low- and middle-income countries.