Objective: To investigate the degree of ventriculomegaly (VM) and its impact on neonatal outcomes. Method: A retrospective analysis was conducted to collect clinical data of 100 pregnant women and their fetuses diagnosed with VM in the Department of Obstetrics and Gynecology of Women & Infant Hospital of Zhengzhou from January 2022 to May 2023. According to the degree of VM, they were divided into mild group (n=62, 10 mm ≤ lateral ventricular width<12 mm), moderate group (n=22, 12 mm ≤ lateral ventricular width<15 mm), and severe group (n=16, lateral ventricular width ≥ 15 mm). Clinical and follow-up data were collected from the three groups, with a focus on analyzing the impact of fetal lateral ventricle widening on neonatal outcomes. Result: The proportion of elderly pregnant women and irrational medication during pregnancy was higher in the severe group than in the other two groups (P<0.05), while there was no significant difference between the mild and moderate groups (P>0.05). Among 100 pregnant women, 22 cases had adverse pregnancy outcomes, accounting for 22.00%. The proportion of elderly pregnant women, those with a history of adverse pregnancy and childbirth, those with pregnancy complications, those who use medication improperly, and those with severe VM in the adverse pregnancy group was higher than that in the successful pregnancy group (P<0.05). 22 cases of VM fetuses with adverse pregnancy outcomes, the mild and moderate groups mainly had digestive system abnormalities and skeletal development abnormalities, with rare central nervous system abnormalities. The severe group mainly showed central nervous system abnormalities, with a significantly higher detection rate than the other two groups (P<0.05). Conclusion: There is a certain relationship between elderly parturients, unreasonable medication during pregnancy, and the degree of VM widening. As the degree of VM widening increases, it will increase the risk of adverse pregnancy outcomes in fetuses, especially with a higher risk of central nervous system abnormalities.