Objective: The objective of this study is to identify the effects of Coronavirus Disease 2019 (COVID-19) on liver enzymes in pregnant patients and to determine the significance of transaminitis as a predictor of worse clinical outcomes. Design: Case series. Setting: Tertiary care medical center. Population: 31 pregnant patients with a positive COVID-19 polymerase chain reaction (PCR) test and 20 infants who presented during March 25, 2020, to May 26, 2020. Methods: Maternal and neonatal outcomes were compared between patients with transaminitis and without transaminitis using one tailed Mann-Whitney test for nonparametric data and the fisher’s exact test for categorical data. Main outcome measures: Worse maternal outcomes between the groups were defined as need for intubation, oxygen supplementation, intensive care unit (ICU) admission, maternal death, and length of hospital stay. Results: Of the 31 patients with COVID-19, 10/29 (34.5%) were found to have transaminitis. The patients with transaminitis had increased oxygen requirements, increased rate of intubation and ICU admissions. Neonatal outcomes in patients with transaminitis included earlier gestational age at delivery and lower birth weights, but neither were statistically significant. Conclusion: Our study revealed that patients with COVID-19 and concomitant transaminitis had worse clinical outcomes in the mother when compared to those without transaminitis. Further studies should be conducted to explore this link between abnormal liver studies and poor outcomes in pregnant patients diagnosed with COVID-19. Keywords: Coronavirus, COVID-19, transaminitis, pregnancy Tweetable abstract: Pregnant patients with COVID-19 and transaminitis had worse outcomes than ones without transaminitis.