Background: This scoping review examines the existing literature on pregnancy and perinatal outcomes among Pacific Islander women in the United States (U.S.) and U.S.-affiliated Pacific Islands. Objective: Specifically, we aimed to identify research that disaggregated Pacific Islanders from any other population group. Search Strategy: We conducted a systematic search of MEDLINE (Ovid), Embase (Ovid), CINAHL (EBSCO), and PsycINFO (Ovid) electronic databases, and hand searched grey literature. Data collection and analysis: We extracted and synthesized data on the study characteristics and pregnancy and perinatal health outcomes. Main results: Forty-eight articles published between January 2010 and June 2020 were included in the review. The majority of studies utilized clinical record data were conducted in Hawaii. Infant outcomes (preterm birth, birth weight) were more commonly reported than maternal outcomes related to either pregnancy health or the perinatal period. Our findings highlight several limitations of the existing literature, including continued aggregation of Pacific Islanders with Asian Americans and other ethnic groups, little comparison between Pacific Islander sub-groups, lack of definition of the nationality/ethnic composition of Pacific Islander groups, a lack of hypothesis-driven primary data collection and clinical trials, and underrepresentation in population-based studies. Conclusion: Researchers and policymakers should aim to address these limitations to better understand pregnancy and perinatal outcomes among Pacific Islanders.