Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune inflammatory demyelinating disorder of the central nervous system characterized by recurrent optic neuritis and longitudinal extensive transverse myelitis. It frequently occurs in childbearing-age women. Pregnancy is regarded as a possible independent risk factor for disease relapse. Many female patients were advised not to be pregnant, given concerns about disease exacerbation. With the accumulation of clinical experience and the progress in research of this disease, we found that NMOSD patients could have safe pregnancies with minimum damage to the fetus under reasonable planning and effective immunosuppressive treatments. Conceiving after remission for at least six months and maintaining immunotherapy during pregnancy and postpartum periods may be helpful to decrease the risk of pregnancy-related relapse.