Background and aim: Although urolithiasis is not common in pregnancy, but is the most common nonobstetric complication in pregnant women. It can associate with significant potential risks for both mother and fetus and needs multi-disciplinary and perfect team work. Diagnosis and management are challenging because of physiological changes and limitation of radiation exposure during pregnancy.
Material and Methods:: 80 articles that discussed about consensus and controversies of the urolithiasis in pregnancy were extracted from PubMed and Medline. 
Results:: Ultrasound is the first choice as a diagnostic imaging tool, but if not conclusive other options should be considered.
Fortunately, conservative management is successful in most of cases, but if failed temporary or definite management may help the patient. However, percutaneous nephrostomy and stent insertion are considered as standard and classic methods, ureteroscopy and endoscopic lithotripsy also seems safe in special situations.
Extracorporeal shock wave lithotripsy is contraindicated during pregnancy and percutaneous nephrolithotomy also is not recommended.
Conclusion: To manage such situation a team work approach is needed involving the patient, urologist, radiologist, anesthesiologist and obstetrician so to achieve the best results and the least risks for mother and fetus.