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Influenza testing and case-confirmation rates in pregnant populations have not been reported during the coronavirus disease 2019 (COVID-19) pandemic. Using electronic medical record data from a cohort of nearly 20,000 pregnancies in the United States, this retrospective cohort study examines the frequency of acute respiratory or febrile illness encounters, influenza testing, and influenza positivity during the 2020-2021 influenza season, which occurred during the COVID-19 pandemic, compared with the 2019-2020 influenza season, which largely did not. The ratios of influenza tests to acute respiratory or febrile illness visits were similar in the 2019-2020 and 2020-2021 influenza seasons (approximately 1:8 and 1:9, respectively) but were low and varied by study site. Although influenza testing in pregnant patients continued in the 2020-2021 season, when severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) circulation was widespread in the United States, no cases of influenza were identified in our study cohort., Competing Interests: Financial Disclosure Flor M. Munoz disclosed that money was paid to their institution from NIH, Pfizer, Gilead, and the CDC. They received payment from DSMB Moderna and royalties from UpToDate. Erin Nicholson received payment from Novavax. Allison L. Naleway's institution received funding from Pfizer and Vir Biotechnology for unrelated studies. Ms. Hadden, Ms. Juergens, Dr. Newes-Adeyi, and Mr. Reichle conducted this work through their employment with Abt Associates. The other authors did not report any potential conflicts of interest., (Copyright © 2022 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.)