Pregnancy and delivery management in patients with moyamoya disease requires careful attention because of the increased risk of cerebrovascular events. Prepregnancy evaluation, including radiological imaging, neurological assessment, and medication adjustment, is essential. During pregnancy, blood pressure(BP) should be monitored closely to prevent complications, because patients are prone to developing high BP. Delivery should be planned based on the patient's cerebrovascular condition, with vaginal delivery under epidural analgesia management or cesarean section in high-risk cases. Postpartum care includes managing BP and monitoring stroke symptoms. Multidisciplinary collaboration between obstetricians, neurologists, and anesthesiologists is crucial for optimizing outcomes.