Background: Asthma exacerbations during pregnancy have been associated with an increased risk of adverse perinatal outcomes. Asthma control through inflammatory mechanisms is hypothesized to worsen in the case of obesity during pregnancy. However, the scientific evidence regarding the association between the two variables remains contradictory. Therefore, this evidence-based case report aims to determine the association between early-pregnancy obesity and asthma exacerbation during pregnancy by synthesizing findings from various related studies. Methods: A literature search was conducted using relevant keywords in the databases PubMed, ScienceDirect, Cochrane, and ClinicalTrials.gov. The Oxford Centre for Evidence-Based Medicine (CEBM) framework was used to appraise the studies that met the inclusion and exclusion criteria. Results: This review identified five studies, comprising one systematic review and meta-analysis and four cohort studies. These studies were appraised as having acceptable validity, importance, and applicability. Four of the five studies reported a significantly increased risk of asthma exacerbation in pregnant women with early-pregnancy obesity. Stevens et al reported a decreased risk of exacerbation among pregnant women with obesity compared with the control group, attributing this to differences in perception thresholds between the groups and the possibility of study bias. Conclusion: Pregnant women with obesity in early pregnancy have a higher risk of experiencing asthma exacerbations during pregnancy compared to non-obese groups. Consequently, these patients require intensified monitoring and optimized asthma management to prevent maternal and perinatal complications.