In a pregnancy complicated by maternal pemphigus vulgaris (PV), pemphigus IgG was found both in the fetal circulation and fixed to fetal epidermis in the characteristic intercellular distribution. Light microscopic examination of fetal skin was diagnostic of PV. These findings indicated transplacental transmission of PV. They also strongly support the pathogenic role of PV antibodies and the concept of PV as a tissue-specific autoimmune disease. The occurrence of intrauterine death despite careful antepartum surveillance underscores the management problems encountered when pemphigus coexists with pregnancy.