Pregnant women with APS are at high risk of maternal and fetal pregnancy complications. Multidisciplinary teams expert in this condition should coordinate management. Even with current management strategies, the risk of maternal thrombosis, fetal loss, or other adverse obstetric outcomes remains. Close monitoring of the various aspects of this condition may reduce maternal morbidity and improve fetal outcome. The pathogenesis of the adverse pregnancy outcome in APS has not yet been fully elucidated, although active research in this field continues. Until this is ascertained, we must accept that many aspects of management are purely empiric, and it is our duty to counsel patients thoroughly so that they understand the risks and benefits of the treatment options they are offered.