This document provides specific recommendations and guidelines to assist physicians in the diagnostic work-up and treatment of surgical problems in pregnant patients, focusing on the use of laparoscopy. Surgical interventions during pregnancy should minimize fetal risk without comprising the safety of the mother. Recent data show the safety and efficacy of laparoscopy during all trimesters for many surgical conditions with outcomes similar to conventional operations. Surgeons must be aware of data regarding differences in techniques used for pregnant patients to optimize outcomes.