The association of persistent presence of circulating antiphospholipid antibodies and thromboembolic events, (recurrent) pregnancy loss or both is termed antiphospholipid syndrome. Pregnancies in women with the syndrome should be regarded as at high-risk for complications. Optimal management consisting of close follow-up and pharmacological treatment can result in about 70-80% live births. Apart from the laboratory diagnosis of the syndrome and pathophysiology, this review will focus on treatment during pregnancy.