Mindfulness-Based Interventions (MBIs) delivered via mobile health (mHealth) platforms have gained attention for improving perinatal psychological health. This review systematically examines the effectiveness of mHealth MBIs in improving perinatal psychological outcomes, including stress, anxiety and depression, with a secondary focus on safety, engagement, acceptability and dropout rates. A systematic search was conducted across PubMed, Cochrane Library, Science Direct, Scopus, ACM Digital Library and IEEE Xplore, along with grey literature, for English-language journal articles from inception until July 2024. All included studies were assessed for methodological quality using standardized critical appraisal instrument. Significant heterogeneity in study designs, program structures and data collection methods precluded meta-analysis, leading to a narrative synthesis of the results. Fifteen studies were included, featuring a mix of quantitative and qualitative designs. Findings indicated that mHealth MBIs demonstrated promise in reducing stress, anxiety and depressive symptoms during pregnancy and postpartum. However, participant engagement in these interventions was influenced by factors such as intervention complexity, user interface challenges and technological issues like app compatibility. Dropouts were commonly attributed to time constraints and technical difficulties, while user feedback emphasized the need for varied and flexible content to sustain interest and perceived effectiveness. Overall, mHealth MBIs offer potential benefits for perinatal psychological health, particularly in reducing stress and anxiety. However, maintaining high engagement and low dropout rates remains a challenge. Future studies should identify optimal intervention formats, enhance adherence and assess long-term impacts of mHealth MBIs to strengthen the evidence base, particularly in diverse settings and for pregnancy-related complications.