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Systemic lupus erythematosus (SLE) is a chronic, multisystem, auto-immune disease predominantly affecting women of childbearing age. 40-60 % of SLE patients will develop renal involvement or lupus nephritis (LN). Pregnancies in patients with (a history of) LN are at high risk for maternal and foetal adverse events, including pre-eclampsia, hypertensive complications, miscarriage, prematurity, and intra-uterine growth retardation. This article aims to give practical guidance to physicians caring for LN patients considering pregnancy, focusing on fertility, absolute and relative contra-indications for pregnancy, contraception, therapeutic strategies and follow-up during pregnancy and postnatal care.