Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease that most commonly affects women of childbearing age. The symptoms of the disease are managed with a multitude of topical and systemic medications. The course of HS changes during pregnancy, and some women can experience postpartum flares. Thus, it is important to be aware of how pregnancy may alter the treatment plan for women and impact their choice to breastfeed. The following review summarizes medical management for HS and its safety during pregnancy and breastfeeding.