We present a descriptive analysis of experience with pregnant women in the intensive care units at a tertiary hospital. During the period from 1983 through 1990, 38 women were admitted to our intensive care units during their pregnancy or within 2 weeks postpartum. This was a rate of 1 per 400 pregnant patients. The mean age of these 38 women was 25 years; 68% of them were white and 32% were primigravidas. Nineteen of the 38 women were mechanically ventilated. Twelve women were admitted for hypertensive disease and 10 for adult respiratory distress syndrome. Maternal mortality was 18% (7/38). Follow-up was available for 33 women. The fetal and neonatal loss rate in this group was 4 of 33 pregnancies. In this case series of 38 very ill women, it was apparent that a team approach of obstetricians, anesthesiologists, and intensive care workers provided optimal management for the mother and child.