This is an update on the treatment of anaphylactic shock in pregnant women. Most guidelines recommend adrenaline as first-line treatment in all patients, but in pregnant patients some recommend ephedrine due to a potential risk of utero-placental hypoperfusion with adrenaline. However, ephedrine is a less potent vasopressor than adrenaline and does not possess the same anti-inflammatory or broncho-dilating effects. As immediate and correct treatment is essential for both the maternal and the fetal outcome, adrenaline should be first-line treatment also in pregnant women.