Molten carbonate fuel cells (MCFCs) are operated at elevated pressure to provide increased operating voltage and/or enhanced CO2 utilization with a cathode input stream having a low CO2 content. It has been discovered that increasing the operating pressure of a molten carbonate fuel cell when using a low CO2-content cathode input stream can provide unexpectedly large increases in operating voltage while also reducing or minimizing the amount of alternative ion transport and/or enhancing CO2 utilization.