The maternal pelvis is a unique osteoligamentous structure that plays a fundamental role in normal vaginal delivery. While obstetric practice primarily focuses on maternal and fetal factors influencing labor, orthopedic understanding of pelvic anatomy, biomechanics, joint mobility, and pelvic morphology is equally important. The bony pelvis serves as the birth canal, and its dimensions, shape, orientation, and dynamic adaptations determine the ease with which the fetal head traverses the pelvic inlet, cavity, and outlet. Although true cephalopelvic disproportion (CPD) is relatively uncommon, abnormalities of pelvic architecture resulting from congenital deformities, trauma, metabolic bone disease, hip disorders, or previous pelvic fractures may significantly influence labor outcomes. Recent evidence suggests that routine pelvimetry alone is a poor predictor of successful vaginal delivery. Modern obstetrics increasingly relies on dynamic assessment through clinical examination and intrapartum ultrasound rather than static measurements. Nevertheless, orthopedic evaluation remains valuable in women with previous pelvic injuries, skeletal dysplasia, acetabular abnormalities, or pelvic reconstructive surgery. This review summarizes pelvic anatomy, biomechanics, orthopedic conditions affecting childbirth, methods of pelvic assessment, and current evidence regarding delivery planning from an orthopedic perspective.