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(BJOG. 2022;129:1644–1652)Pregnancy in women with liver cirrhosis is rare (1 in 4500 pregnancies) and when it does occur, cirrhosis most commonly originates from autoimmune and viral hepatitis, and alcoholic and nonalcoholic fatty liver disease. The concurrence of pregnancy with liver cirrhosis is increasing and this combination warrants careful attention to family planning and obstetric management. Previous small studies have shown cirrhotic pregnancies have high risk of maternal and perinatal morbidity and mortality. This systematic review and meta-analysis combined a larger patient population over time to detail the obstetric, fetal, and maternal complications experienced by women with liver cirrhosis.