The incidence of GERD is high during pregnancy. Hormonal and mechanical factors in pregnancy alter the structure and function of the normal physiological barriers to reflux of gastric contents into the oesophagus. Most of the patient benefit from lifestyle changes, but require pharmacological treatment for full alleviation of their symptoms. Collaboration between obstetricians and gastroenterologists is recommended, with primary focus on the safety of the mother, fetus and neonate. It is recommended to initiate treatment with lifestyle changes and antacids. As a second line histamine-2 receptor antagonists (H2RA) and proton pump inhibitors (PPI) are tried. Careful discussion of the risks and benefits of the therapy with the patient should precede treatment with any of these medications. In patients with no history of GERD, the symptoms usually resolve after delivery.