Pregnancy in systemic sclerosis may be uneventful with good maternal and fetal outcomes. Scleroderma is a multisystem disease and complications do occur; however, careful antenatal evaluations, discussion of potential problems, and participation in a high-risk obstetric monitoring program are important to optimize the best outcome. Women who have diffuse scleroderma are at a greater risk for developing serious cardiopulmonary and renal problems early in the disease so they should be encouraged to delay pregnancy until the disease stabilizes. All patients who become pregnant during this high-risk time should be monitored extremely carefully, particularly for renal crisis.