Background: Oligohydramnios, characterized by an amniotic fluid index (AFI) of ≤5 cm, is associated with increased maternal and perinatal risks, including fetal growth restriction, abnormal labor patterns, and higher rates of operative delivery. Timely identification and intervention are essential to improving outcomes. Aim of the study: To evaluate maternal outcomes in pregnancies complicated by oligohydramnios, with a particular focus on delivery methods, antepartum complications, and the effect of L-arginine supplementation. Methods: This prospective observational study included 115 pregnant women diagnosed with oligohydramnios at Department of Obstetrics and Gynaecology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. Data on maternal demographics, obstetric history, antepartum complications, labor characteristics, and delivery outcomes were collected. Management included hydration, rest, fetal surveillance, and in selected cases, L-arginine therapy. Statistical analysis was performed using SPSS version 26. Result: Most participants were aged 20–34 years (92.17%) and had normal BMI (53.91%). Common complications included anemia (37.39%) and hypertensive disorders (31.30%). Induced labor was required in 75.65% of cases. The most frequent mode of delivery was vaginal (55.65%), followed by emergency cesarean section (33.91%). Emergency cesarean indications were mainly non-reassuring fetal heart rate patterns (79.13%). Conclusion: Oligohydramnios significantly increases the risk of emergency interventions and adverse maternal outcomes. Early detection and close monitoring, along with supportive therapies such as L-arginine, may help optimize maternal and fetal well-being.