Gestational diabetes mellites (GDM) refers to diabetes first diagnosed during pregnancy. The prevalence of GDM is known to be very high among South Asian women. This could be due to genetic susceptibility, and / or high carbohydrate diets coupled with low physical activity. The recent Indian Council of Medical Research (ICMR-INDIAB) study reported the national GDM prevalence to be 22.4% indicating that nearly one in four pregnant women in India has GDM. A substantial proportion of cases are diagnosed before 20 weeks of gestation and this is referred to as ‘Early gestational diabetes (EGDM)’, highlighting the importance of early pregnancy screening for GDM. Compared with late gestational diabetes mellitus (LGDM), EGDM is associated with greater insulin resistance, poorer glycaemic control, increased risk of adverse maternal and neonatal outcomes, and a higher likelihood of postpartum progression to type 2 diabetes. The Treatment Of Booking Gestational diabetes Mellitus (TOBOGM) trial showed the benefits of early treatment of EGDM. Among South Asians, universal early screening of all pregnant women using standardized diagnostic criteria, good control of diabetes and structured postpartum follow-up are essential to improve maternal and offspring health outcomes in women with GDM.