In this video, Aparna Goel, MD, associate professor of medicine at Stanford University, reviews the impact of pregnancy on primary biliary cholangitis (PBC) and key considerations for managing pregnant patients with autoimmune liver disease. The discussion covers how pregnancy affects PBC laboratory markers, including the limitations of alkaline phosphatase as a biomarker, common symptom changes such as worsening pruritus, and the importance of monitoring bile acids, liver enzymes, and fat-soluble vitamins. Medication safety during pregnancy, including continued use of ursodeoxycholic acid, maternal and fetal risk assessment, monitoring for portal hypertension, and postpartum follow-up are also addressed. This practical overview highlights multidisciplinary care and real-world strategies to support safe maternal and fetal outcomes in women with PBC during pregnancy.