Biologic medications have revolutionized the treatment of many dermatologic conditions. However, their use during pregnancy and breastfeeding is a subject of ongoing concern due to limited data on their safety in these populations. As the course of many inflammatory skin conditions is unpredictable during pregnancy and may worsen, biologics are important therapeutic tools for disease stabilization in this patient population. In this review, we provide a comprehensive summary of the gestational safety profile of biologics commonly used in dermatology and provide recommendations during pre-conception, pregnancy, and post-partum periods. We also examine fertility data, placental transfer of biologics, and postpartum immunosuppression/immunomodulation data. J Drugs Dermatol. 2024;23(11):1010-1015. doi:10.36849/JDD.7816R1.