Background: High-risk pregnancies (HRP) need quick and effective healthcare. Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) an Indian maternal health program offers antenatal care especially for, High-Risk Pregnancies (HRP). PMSMA enrolled pregnant women's HRP prevalence and knowledge of government maternal health measures are unclear. This study assess the prevalence of high-risk pregnancies, evaluate maternal health service awareness, and explore influencing factors among PMSMA-enrolled women. Methods: The Jewar Primary Health Centre (PHC) in Gautam Budh Nagar district, an NIIMS Rural Health Training Centre (RHTC), was chosen to undertake a cross sectional study on PMSMA-registered pregnant women from October 23 to Jan 2024. Sociodemographic, obstetric, maternal health, and high-risk pregnancies were obtained using a standard questionnaire. High-risk pregnancies may be predicted by medical and obstetric risk factors. Data was analysed using descriptive statistics and statistical tests to discover variable relationships. Results: PMSMA-enrolled pregnant women had 35% high-risk pregnancies. The mother's education, age of marriage, and other sociodemographic characteristics affected her high risk status. 42% knew about PMSMA and government maternal health services. ASHA contributed 28% of 42% awareness. Conclusion: This research enhances our knowledge of high-risk pregnancy and