OBJECTIVE: To assess the maternal and perinatal outcome of patients with antiphospholipid syndrome in pregnancy. PATIENTS AND METHOD: A descriptive and retrospective analysis of patients with antiphospholipid syndrome in pregnancy was made from January 2000 to June 2005. RESULTS: We analyzed 35 patients. Primary and secondary antiphospholipid syndrome occurred in 25 (71%) and 10 (29%) women, respectively. Nine cases were associated with systemic lupus erythematosus and one with scleroderma. Approximately, 48% of women had history of thrombosis, 23% recurrent pregnancy loss, and 15% early onset preeclampsia in previous pregnancies. Twenty-seven patients had positive anticardiolipin antibodies, 6 lupus anticoagulant, and 2 both of them. About 80% of the patients were delivered by cesarean section. There was one spontaneous embryo loss before seven weeks. Eleven (32%) patients had preeclampsia. There were no maternal deaths. All women began treatment since the first trimester of pregnancy. Twenty-three patients (66%) received heparin and low dose aspirin, 8 cases (22%) heparin, low dose aspirin and prednisone, for presenting systemic lupus erythematosus, and the remaining 4 cases (12%) were treated with prednisone and aspirin. Ninety four percent of the cases got a live newborn. There were two neonatal deaths secondary to extreme prematurity and associated with preeclampsia. There was one fetal death related to maternal lupus renal activity. Fifty-eight percent of the newborns were premature. Intrauterine growth restriction was present in 20% of the cases. CONCLUSIONS: Early treatment combined with close maternal-fetal surveillance was associated with a 90% chance of a live birth rate. However, prematurity, preeclampsia and intrauterine growth restriction were common.