Objective: Antiviral therapy during pregnancy has always presented difficulties in clinical practice. This review covers the safety and efficacy of the direct use of antivirals during pregnancy. Mechanism: We conducted literature research to summarize the available evidence on the use of direct-acting antivirals during pregnancy for infections due to influenza, hepatitis B and C, human immunodeficiency, herpes simplex virus, cytomegalovirus, varicella-zoster virus, Ebola, and Zika viruses, and human coronavirus. Findings in brief: To support further the rational use of antivirals during pregnancy, the discussion includes the influence of pregnancy on pharmacokinetics, safety, and transplacental permeability, and the protection of mothers and children from vertical transmission. Conclusion: Data on the use of antiviral drugs during pregnancy are currently insufficient. Promoting research on the ethics of drug experimentation, and pharmacokinetics, drug metabolism, and pharmacological effects of pregnancy, is essential to improve the care of pregnant women and even save lives during current and future outbreaks.