Any medical disease during pregnancy is fraught with additional apprehension about the additional effect of the medical condition on the mother and baby. The clinical approach and decisions might change depending upon whether it is the first clinical presentation during pregnancy or had been a medical problem, now having associated pregnancy. Important considerations in the care of women with epilepsy (WWE) that must be taken before and during pregnancy include teratogenic risk, change of antiepileptic drug (AED) concentrations during pregnancy, postpartum, and lactation. This chapter attempts to describe the disease burden of epilepsy in WWE, preconception counseling, clinical features, obstetrical management, and follow-up.