Background: Waterpipe use is a significant factor in female tobacco consumption, particularly in the Middle-East, where it is perceived as a symbol of social emancipation. While cigarette smoking remains socially discouraged for women, waterpipe smoking has gained cultural acceptance. This study examined changes in waterpipe smoking patterns among Jordanian women before, during, and after the holy month of Ramadan. Methods: A descriptive, repeated-measure design was used to assess waterpipe smoking among women recruited from maternal outpatient clinics. Data were collected at three time points: two weeks before, during, and two weeks after Ramadan, using the Women’s Smoking Questionnaire. Results: Overall smoking status remained stable across the three periods; a slight change in waterpipe smoking status was observed at the three time points: before Ramadan (86.2%), during Ramadan (80.3%), and after Ramadan (82.5%). Smoking status was significantly associated with social judgment and the perceived “attractiveness” of women waterpipe smokers. Conclusion: This study is among the first to document the stability and periodic increases in women’s waterpipe smoking habits during Ramadan. The findings suggest that waterpipe smoking is a deeply entrenched social ritual rather than a purely nicotine-seeking behavior. Nursing implications: Nurses should implement culturally sensitive screening that specifically includes waterpipe smoking.