Data support an increase in adverse outcomes in the pregnant woman with asthma, particularly those who are poorly controlled. Additionally, pregnancy is recognized to influence the course of asthma. Hormonal and physiologic changes are felt to direct the eventual course and outcome, but their roles are incompletely understood. Because of the potential for life-threatening consequences to mother and fetus, aggressive asthma management, as in the nongravid female, is recommended. Therapy may include controller agents such as cromolyn, beclomethasone, and the newer inhaled steroids. The newer antileukotriene agents may have a role in some patients. Reliever therapy with short-acting B2 agonists and, if needed, oral corticosteroids are indicated for acute exacerbations. Because of the potential for maternal and fetal harm, close monitoring of mother and child is essential.