Whilst MPN are traditionally considered diseases of adults in their sixth or seventh decade these conditions do occur in young patients for example for essential thrombocythaemia in particular there is a second peak in women of reproductive age. Pregnancy therefore is an uncommon but not rare occurrence and clinical challenge in some scenarios. Here we discuss in detail our local approach to the management of pregnancy in MPN patients taking a case-based approach. We take time to include relevant updates in the field and point to a future research strategy which should be internationally focused in order to obtain as much information in as short a time as possible.