Over 8 million cases of tuberculosis will occur in the world next year. Most of these cases will occur in young adults, so women of child-bearing age are at significant risk for both tuberculosis infection and disease. Although older literature emphasized reciprocal harmful effects of pregnancy and tuberculosis, with prompt diagnosis and early institution of proper therapy, a good outcome for mother and child should be the rule. Many pregnant women are good candidates for screening for tuberculosis infection, and some should receive preventive therapy before delivery. Active tuberculosis in pregnancy should be aggressively investigated and must always be treated. HIV infection and drugresistant tuberculosis present special challenges in pregnancy, and knowledge of drug interactions and teratogenic effects of antiretrovirals and second-line antituberculosis agents is needed to manage these patients properly.