Abstract Pharmacotherapy for the management of common gastrointestinal illnesses continues to evolve. Women with chronic illnesses who would have been unwilling or unable to conceive in the past are now healthy enough to consider pregnancy. In addition, many women are deferring childbearing until later in life, when polypharmacy and illness may be more common. This chapter discusses the use of medications during pregnancy according to the best available evidence. Because the amount of high-quality controlled data in pregnancy is limited, absolute safety is not guaranteed with any medication. This chapter covers the treatment of common gastrointestinal and liver diseases, the management of common gastrointestinal symptoms, and the use of medications during endoscopy.