PURPOSE To evaluate the occurrence of pregnancy after bone marrow transplantation (BMT). DESIGN Medline literature review of reported pregnancies in the BMT population published in the English language. RESULTS Multiple case reports and a few series studies showed more than 250 offspring from BMT recipients. CONCLUSION BMT patients receive high-dose chemotherapy and often radiation, as well. These agents are associated with gonadal dysfunction and the fertility of patients after BMT is of concern because BMT patients are often young people who wish to resume a normal quality of life, which for many patients involves the desire to have children. Our experience with the successful pregnancy of one of our BMT patients led to the investigation of reported cases that showed numerous other births. The issue of counseling BMT patients about fertility, pregnancy complications, and potential birth defects is becoming increasingly complex and warrants further investigation.