Gestational weight gain (GWG) exceeding recommended guidelines poses significant risks to maternal and fetal health. While exercise interventions during pregnancy have been extensively studied, limited evidence exists regarding their comprehensive impact on both GWG and fetal outcomes. This randomized controlled trial aimed to evaluate the effect of an early, structured exercise program on GWG and fetal outcomes in a diverse cohort of pregnant women. Participants (n=200) were randomized into an intervention group receiving supervised aerobic and resistance training sessions three times weekly from gestational week 12 to 36 and a control group receiving standard antenatal care. Results demonstrated statistically significant reductions in GWG in the intervention group compared to controls (mean ± SD: 10.4 ± 2.5 kg vs. 13.1 ± 3.2 kg; p<0.001). Additionally, the incidence of macrosomia was significantly lower in the intervention group (6% vs. 14%; p=0.032). Neonatal outcomes, including Apgar scores and birth weights, were within healthy ranges in both groups, emphasizing the safety of the intervention. This study presents novel evidence supporting early exercise interventions in mitigating excessive GWG and improving fetal outcomes. These findings highlight the importance of incorporating structured exercise into routine prenatal care to enhance maternal and neonatal health outcomes.