Purpose: To assess the quality of care for pregnant women with epilepsy in Lithuania. Method: We retrospectively analysed 100 pregnancy case histories of 96 women with epilepsy who gave birth to 100 babies at the Hospital of Kaunas University of Medicine from 1998 - 2001. These comprised 0.9% of all deliveries at this hospital, which usually accepts all complicated pregnancies from approximately half of the country. Results: Pregnancy did not influence the course of epilepsy in 58% cases, in 21% the seizures decreased, in 21% they worsened. Just 10 out of 21 searched for medical help because of seizure increase, and treatment was changed in 4 cases. Antiepileptic drug (AED) treatment during pregnancy was used in 67% cases. Carbamazepine was used in 41%, valproate in 12% of cases; newer AEDs were not used. AED plasma concentration was investigated in 2 cases. Folic acid was taken before pregnancy by 1%, within the 1st trimester of pregnancy by 9% of patients. Just 15% of patients visited a neurologist and 41% visited a gynaecologist within the 1st trimester of pregnancy. Ultrasound testing within 18-20 weeks of pregnancy was not performed in 65% of cases (58% of them were on AEDs). Alpha-fetoprotein test was performed in 7 cases on treatment. In 9 cases the ante-natal diagnostics met the recognised guidelines for management of pregnancy in women with epilepsy. Conclusion: The care for women with epilepsy in Lithuania is far from satisfactory. National guidelines for management of pregnancy in women with epilepsy might give an impulse to the improvement of the situation.