Approximately 50% of pregnant women experience low back and lower extremity pain during pregnancy, many of which continue to experience pain postpartum. It is known that many women experience changes in foot size, arch height and lower extremity alignment. However, the mechanism by which these changes are related to pain is relatively unknown, specifically in regard to asymmetric changes in alignment. Therefore, the purpose of this study was to assess alignment during pregnancy in order to determine if asymmetries occurring in women during pregnancy are related to low back, hip, knee, and foot pain. Methods:​ Ten women in their third trimester of pregnancy and nine nulliparous controls were recruited to participate. Biomechanical measures of foot length, foot width, arch index, arch height index, arch rigidity index, arch drop, and rearfoot angle were taken bilaterally to assess asymmetry. Pelvic asymmetries were assessed in the frontal and sagittal plane. Musculoskeletal pain was assessed using a Visual Analogue Scale. Pregnant women were placed into a ‘pregnant pain’ group (n=5) and a ‘pregnant no pain’ group (n=5) based on results of this scale. Results/Conclusion:​ A relationship between lower extremity asymmetries and pain during pregnancy does exist. Specifically, negative correlations were found between arch index asymmetry and low back pain (p=0.005), foot length asymmetry and lower leg pain (p=0.008), and pelvic obliquity and lower leg pain (p=0.020). Significant positive correlations were found between foot width asymmetry and knee pain (p=0.028), as well as arch drop asymmetry and upper leg (p=0.024), knee (p=0.005), and lower leg pain (p=0.019). This study was successful in identifying a few target areas for clinicians to treat pain, but requires a much larger sample size in order to establish differences between pregnant women who experience no pain and pregnant women who do experience pain. Because low-back and lower extremity pain is extremely prevalent in post-partum women, it is important to conduct further research in order to determine both whether these asymmetries are related to pain post-partum, and if treating these asymmetries is preventative of pain post-partum.