This chapter reviews some of the clinically important issues surrounding pregnancy and antiepilepsy drugs (AED) exposure. One-quarter to one-third of woman with epilepsy (WWE) will have an increase in seizure frequency during pregnancy. A number of adverse outcomes of pregnancy are known to occur more often in infants of mothers with epilepsy (IME). Five clinical syndromes have been reported in IMEs: fetal trimethadione syndrome, FHS, a primidone embryopathy, a fetal valproate syndrome and a fetal carbamazepine syndrome. There have been case reports of anomalies associated with exposure to the newer, AEDs, but no drug-specific syndrome of anomalies described. While pregnancy, maternal seizures and AEDs pose risks for successful pregnancy outcome, the majority of patients can and do have healthy children. Valproic acid (VPA) has in addition to the underlying increased risk for malformations an additional risk for development of neural tube defects (NTDs).