Background Ovulation induction is essential in managing anovulatory infertility. Clomiphene citrate, often the first-line agent, can be insufficient for some patients due to underlying endocrine factors. This study evaluates the effectiveness of adding dexamethasone to clomiphene citrate to improve ovulation and pregnancy outcomes in women with anovulatory infertility. Methodology This prospective observational study was conducted from Feb 2022 to Feb 2023 at Liaqat Memorial Hospital affiliated with KMU-IMS, Kohat and included 100 women aged 20 to 35 years with anovulatory infertility. Participants were divided into two groups: one receiving clomiphene citrate alone and the other receiving clomiphene citrate combined with dexamethasone. Ovulation and pregnancy rates were assessed through ultrasound and serum beta-hCG measurements. Baseline hormonal levels, follicle size, and endometrial thickness were monitored to evaluate response. Results Conclusion The group receiving clomiphene citrate combined with dexamethasone showed a significantly higher ovulation rate (80%) compared to the clomiphene-only group (60%). Pregnancy rates were also notably higher in the combination group (36% vs. 20%). Improvements in average follicle size and endometrial thickness were observed in the dexamethasone group, suggesting enhanced uterine conditions for implantation. Side effects, including weight gain and mood changes, were mild and comparable between groups. Adding dexamethasone to clomiphene citrate improves ovulation and pregnancy outcomes without significant side effects, particularly benefiting patients resistant to clomiphene alone. This combined protocol shows promise as a valuable option for treating anovulatory infertility, meriting further research in larger studies.