In recent years, evidence has emerged implicating a previously unappreciated role for maternal nutrition before and during pregnancy on offspring health beyond fetal and neonatal life. Studies from human and animal cohorts have indicated that unbalanced nutrition, including caloric restriction or excess, or a lack of adequate micronutrient intake, can have negatively affect fetal growth, and have chronic impacts on offspring cardiometabolic and reproductive health. Here we review how maternal nutrient imbalance during pregnancy can affect fetal growth trajectory, pregnancy outcomes, and prime offspring for chronic disease in adult life, as well as ways in which these so-called “programming” effects can be ameliorated by interventions during and after gestation.