Diabetic retinopathy is the most common chronic complication of diabetes mellitus 1 and is the most common cause of blindness in middle-aged subjects in the United States and the United Kingdom. 2 5 The mutual effects of pregnancy and retinopathy, though long a subject of research and debate, remain unclear, and data on methods of diagnosis and management in pregnancy remain scarce. 6 10 The purpose of this chapter is to review the current literature on the effects of pregnancy on diabetic retinopathy and to provide guidelines for the management of pregnancies complicated by diabetic retinopathy.