INTRODUCTION: Physical activity is known to improve physical and psychological outcomes in pregt women. While aerobic exercise is typically emphasized in physical activity guidelines for pregt women, emerging research suggests that strength training may offer unique benefits beyond those provided by aerobic exercise alone. This systematic review aimed to systematically explore the effects and characteristics of strength training interventions on the health-related quality of life of pregt women, with the goal of informing more comprehensive and specific exercise guidelines. MATERIAL AND METHODS: A systematic literature search was conducted across PubMed, Web of Science, and EBSCO Host databases without time restrictions, following PRISMA guidelines (PROSPERO ID: CRD42024511477). Nine randomized controlled trials met the inclusion criteria, involving a total of 1581 participants. RESULTS: The studies reviewed demonstrated that strength training during pregcy can mitigate excessive weight gain, alleviate low back and sciatic pain, enhance mood, and improve various aspects of health-related quality of life. These aspects include physical activity levels, muscular strength, flexibility, sleep quality, energy expenditure, and psychological well-being. CONCLUSIONS: Despite these promising findings, this review highlights the need for standardized methodologies and detailed reporting in future research. Incorporating strength training into general exercise recommendations for pregt women has the potential to optimize maternal health outcomes such as muscle strength, weight gain, physical activity levels, low back pain, pelvic pain, fatigue, anxiety, energy levels, vitality, sleep duration, and health status.

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