Gastrointestinal endoscopy is conquering various milestones not only in diagnostics but also in therapeutic endoscopy. However, limited studied are available about its safety and efficacy in pregnant patients. Hospital admission, pre-procedure risk assessment by obstetrician, perinatologist, anaesthetics and gastroenterologist is important. Endoscopy should be performed with strong indications only. ERCP should be performed with therapeutic intent by expert endoscopist. This review will address basic clinical questions when performing endoscopy in pregnancy.