This systematic review evaluates the evidence of the impact of multiple-micronutrient supplements during pregnancy, in comparison with standard iron–folic acid supplements, on specific maternal and pregnancy outcomes of relevance to the Lives Saved Tool (LiST). The evidence from 17 studies suggests a significant benefit of multiple-micronutrient supplementation during pregnancy in reducing small-for-gestational-age births as compared to iron–folic acid alone, with no significant increase in the risk of neonatal mortality in populations where skilled birth care is available and the majority of births take place in facilities.