OBJECTIVES: Because of the large number of cases of visceral leishmaniasis (VL) recorded in Brazil over the last few years, this disease has been showing characteristics different from previously known ones. We report cases of pregnant women treated for VL, describing their course and outcome and the chemotherapeutic medication used according to the clinical signs and symptoms of each patient. STUDY DESIGN: We report five cases of pregnant women treated for VL in a central-western region of Brazil. RESULTS: No case of vertical transmission was observed, even in patients who were treated after delivery. One of the patients with a late diagnosis made after the onset of symptoms died. Thus, the treatment of VL during pregnancy reduces maternal mortality and the rate of vertical transmission of the disease, being safe and effective as long as the disease is diagnosed early. CONCLUSION: At present, amphotericin B and its derivatives appear to be the best therapeutic option for the mother-child binomial.