Respiratory complaints are common symptoms in pregnancy, and it is important to delineate whether the causative factor is cardiac, pulmonary, or physiologic in origin. The pathophysiology of Sickle Cell Disease (SCD) can further complicate the differential diagnosis. To our knowledge, there is little to no literature devoted to the management of pulmonary complications in the pregnant sickle cell patient. Therefore we present a review of the current literature and feature reports on the incidence and prevalence of the pulmonary complications in a sickle cell pregnancy. These include Acute Chest Syndrome (ACS), Pulmonary Hypertension (PH), Pulmonary Embolism (PE), and sickle cell chronic lung disease. We also aim to recommend management strategies that address the SCD-related pulmonary complications in the pregnant state.