Seven successful pregnancies in patients following TRAM flap reconstruction were reviewed. These patients, who had one or both rectus muscles used in the reconstruction, had normal pregnancies, and all but one had normal vaginal delivery. The TRAM baby weights were from 6 pounds, 1 1/2 ounces to 8 pounds, 4 1/2 ounces. No abdominal revisions were required after delivery. The only advice we gave our patients and their obstetricians was to treat a post-TRAM flap pregnancy as any other pregnancy. This review confirms that TRAM flap reconstruction will not prevent a normal pregnancy and delivery if the abdomen is repaired as practiced by the senior author (Hartrampf) in this series of patients.