Peptic ulcer disease (PUD) in pregnancy should be considered separately from PUD in the general population. This article focuses on how the clinical presentation, natural history, medical therapy, and surgical therapy of PUD differ in pregnancy from that in the general population to help the clinician to evaluate, manage, and treat PUD during pregnancy and to stimulate the researcher to study the role of Helicobacter pylori in ulcerogenesis and to perform controlled endoscopic studies during pregnancy.