The article reviews the epidemiology of smoking during pregnancy, focusing on smoking prevalence, maternal characteristics, and pregnancy outcomes. Smoking prevalence varies significantly across countries, with some industrialized nations experiencing a decline and others seeing an increase among young women. Smoking during pregnancy is recognized as a major preventable risk factor for adverse pregnancy outcomes, including fetal growth restriction, stillbirth, preterm birth, placental abruption, and potentially sudden infant death syndrome (SIDS). Smoking is also associated with increased risks of spontaneous abortions, ectopic pregnancies, and placenta previa, and may contribute to behavioral disorders in children. The article discusses the time trends in smoking rates among women, noting that while smoking prevalence has generally decreased over the past decades, it remains a significant issue among young women. Smoking cessation rates have increased, but interventions during pregnancy have had limited success. Maternal education and socioeconomic status are important factors influencing smoking prevalence and cessation. The article also examines the reproductive outcomes associated with smoking during pregnancy, including infertility, ectopic pregnancy, spontaneous abortions, placental complications, and adverse pregnancy outcomes such as fetal growth restriction, preterm birth, perinatal mortality, and congenital malformations. Smoking is particularly linked to an increased risk of stillbirth and SIDS, with dose-response relationships observed across different populations. Finally, the article explores the long-term effects of smoking during pregnancy on children, including increased risks of hospitalization, respiratory disorders, behavioral and psychiatric diseases, and childhood cancers. The review highlights the need for continued efforts to reduce smoking prevalence and improve smoking cessation rates among pregnant women to protect maternal and fetal health.The article reviews the epidemiology of smoking during pregnancy, focusing on smoking prevalence, maternal characteristics, and pregnancy outcomes. Smoking prevalence varies significantly across countries, with some industrialized nations experiencing a decline and others seeing an increase among young women. Smoking during pregnancy is recognized as a major preventable risk factor for adverse pregnancy outcomes, including fetal growth restriction, stillbirth, preterm birth, placental abruption, and potentially sudden infant death syndrome (SIDS). Smoking is also associated with increased risks of spontaneous abortions, ectopic pregnancies, and placenta previa, and may contribute to behavioral disorders in children. The article discusses the time trends in smoking rates among women, noting that while smoking prevalence has generally decreased over the past decades, it remains a significant issue among young women. Smoking cessation rates have increased, but interventions during pregnancy have had limited success. Maternal education and socioeconomic status are important factors influencing smoking prevalence and cessation. The article also examines the reproductive outcomes associated with smoking during pregnancy, including infertility, ectopic pregnancy, spontaneous abortions, placental complications, and adverse pregnancy outcomes such as fetal growth restriction, preterm birth, perinatal mortality, and congenital malformations. Smoking is particularly linked to an increased risk of stillbirth and SIDS, with dose-response relationships observed across different populations. Finally, the article explores the long-term effects of smoking during pregnancy on children, including increased risks of hospitalization, respiratory disorders, behavioral and psychiatric diseases, and childhood cancers. The review highlights the need for continued efforts to reduce smoking prevalence and improve smoking cessation rates among pregnant women to protect maternal and fetal health.