Although epilepsy is one of the most common neurological diseases today, it still represents a significant medical and public health issue, especially in specific groups of patients such as pregnant women. Pregnancy, itself, is a period in which women's physiology and psychology changes. When pregnancy is accompanied by a severe disease, it is unambiguous how difficult it is to keep the disease under control and not harm the woman nor her child at the same time. Pregnant women with epilepsy are a high-risk group and because of this, they require constant monitoring during pregnancy, both from gynecologists and epileptologists. Pre-planned pregnancy, receiving appropriate therapy during pregnancy and regular frequent medical examinations should result in a normal pregnancy and birth without any complications. The main goal of anti-epileptic therapy in pregnant women is to achieve a balance between complete control of epileptic seizures with minimal dosage of the drug and potential teratogenic effects of anti-epileptic drugs (AEDs). It should be stressed to pregnant women that a high percentage of pregnancies are considered to be normal and do not have complications whereas the frequency of congenital malformations depends on the type, dosage and number of anti-epileptics. Valproates should be avoided because of its teratogenic potential. Lamotrigine, carbamazepine, levetiracetam and oxcarbazepine are recommended due to their minimal effect on the fetus. Taking folic acid is highly recommended during pregnancy in order to prevent the formation of neural tube defects and in the last month of pregnancy vitamin K should be taken to prevent neonatal hemorrhage after delivery. Breastfeeding is also highly recommended considering the fact that it results in various positive effects on the mother and the child but monitoring serum concentrations of the drugs in the child is sometimes necessary.