Acoustic neuroma in the pregnant patient has been described infrequently. The symptoms of acoustic neuroma can commence or worsen during the last 3 or 4 months of pregnancy. In women, acoustic tumors have been shown generally to be larger and more vascular, and some acoustic tumors contain estrogen receptors. This is a report of our management of two patients with acoustic neuroma who presented early in pregnancy. Surgery was delayed to the second trimester in each, to avoid spontaneous abortion. Both patients underwent translabyrinthine tumor removal at 18-19 weeks gestation, and each had an uncomplicated postoperative course. Examination of the tumor for estrogen receptors was performed for the second patient and was negative. Uncomplicated acoustic neuroma surgery can be performed in pregnant patients during the second trimester.