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Background: Low back pain is a common condition affecting pregnant women that arises from hormonal and biomechanical changes that alter posture, gait, and balance. Traditional studies focus on general biomechanical adaptations, often neglecting dynamic plantar pressure changes, left-right foot asymmetries, and their link to low back pain. Objectives: To study the effects of plantar pressure analysis on walking and balance, and to explore the relationship between plantar pressure and low back pain in pregnant women. Methods: This was a cross-sectional study of 85 pregnant women recruited through simple random sampling and participated in a 10-meter walk test using SuraSole insoles to collect plantar pressure data across eight-foot zones. Data were analyzed using descriptive statistics, paired t test assessed plantar pressure differences between the left and right feet in the pregnant women, and Pearson correlation, paired measurements, and relationships involving continuous variables.The Scheffe’ method was used to test the mean of each pair of means. The relationship between low back pain and plantar pressure using a multiple linear regression analysis. Results: Pregnant women exhibited significantly higher plantar pressure in the forefoot and heel zones (P < .05). Pregnant participants showed significantly greater plantar pressure in the left heel, medial forefoot, and medial midfoot than the right side (P < .01), reflecting left-side dominance. Plantar pressure positively correlated with gestational age and body mass index. Heel pressure was strongly associated with lower back pain, while toe and forefoot zones showed weaker correlations. Conclusions: Pregnancy affects plantar pressure distribution and foot asymmetry. Increased plantar pressure, particularly in the heel zone, strongly correlates with low back pain. Left-right foot asymmetries in the pregnant women emphasize the need for targeted interventions, such as improving gait mechanics and suitable shoes and promoting walking exercises to reduce low back pain during pregnancy.