Systemic lupus erythematosus is an autoimmune disease that primarily affects women of reproductive age. Although advances in science and in the therapeutic approach have made it possible to carry out pregnancy for most patients with the underlying diagnosis, pregnancies are still considered high-risk, both for the mother and for the fetus. Approximately half of the patients experience an exacerbation of the disease during pregnancy, and pregnancy loss, hypertensive complications, intrauterine growth retardation, premature birth and neonatal lupus are possible complications that are more common in these pregnant women compared to healthy pregnant women. Preconception counseling and careful pregnancy planning and management are necessary to reduce the risk and have a successful pregnancy outcome. The use of many drugs that are normally used in the treatment of patients with systemic lupus erythematosus is contraindicated or significantly restricted during pregnancy. Physiological changes during pregnancy can make the symptoms of the disease less recognizable, and pregnancy disorders such as preeclampsia are sometimes difficult to distinguish from an exacerbation of the disease. It is clear that pregnancies of patients with systemic lupus erythematosus always require careful supervision and cooperation of subspecialists perinatologists and immunologists in order to make timely and correct decisions which can reduce potential risks for mother and child and increase the success of pregnancy.