Neurological diseases during pregnancy encompass a wide spectrum of conditions, including primary and secondary headaches, epilepsy, demyelinating central nervous system disorders, neuromuscular diseases, stroke, and movement disorders. These conditions pose unique diagnostic and therapeutic challenges due to the need to balance maternal health with fetal safety. Headaches, particularly migraines, are common but may improve in the second trimester, while secondary causes such as preeclampsia, cerebral venous thrombosis, and posterior reversible encephalopathy syndrome require urgent attention. Epilepsy management focuses on maintaining seizure control while minimizing teratogenic risks, with lamotrigine and levetiracetam generally preferred over valproate. Demyelinating disorders, including multiple sclerosis and neuromyelitis optica spectrum disorders, necessitate tailored disease-modifying therapy plans and vigilant postpartum relapse prevention. Neuromuscular disorders, such as myasthenia gravis, Charcot-Marie-Tooth disease, and inflammatory myopathies, may worsen during pregnancy, requiring individualized treatment adjustments. Pregnancy-related stroke, though rare, carries significant morbidity and mortality, emphasizing the need for rapid diagnosis and multidisciplinary care. Movement disorders, including restless legs syndrome and chorea gravidarum, present with variable maternal and fetal risks and require cautious pharmacological intervention. This chapter highlights the importance of preconception counseling, careful medication selection, and multidisciplinary collaboration to optimize maternal and neonatal outcomes in neurological diseases during pregnancy.