OBJECTIVE:: In a retrospective study, the prevalence of preeclampsia in patients with renal FMD was estimated to 52% (Vance et al., 2015). The aim of our study was to assess the prevalence and nature of pregnancy-related complications in patients with FMD. DESIGN AND METHOD:: A call for participation was sent to all centres contributing to the European/International FMD registry (EIFR). Eleven centres volunteered to participate. All patients with at least one pregnancy were included. Data on pregnancy and/or peripartum complications were collected through medical files and/or patient interviews. Data on FMD characteristics were collected through the FMD registry. RESULTS:: Data from 446 pregnancies were obtained in 197 patients (age at FMD diagnosis: 48 ± 14 years, 90% renal, 77% multifocal). Forty% of women (n = 78) experienced pregnancy-related complications. However, the latter mostly corresponded to hypertension during pregnancy (22%) and preterm birth (20%), while preeclampsia was reported in only 6%. Preeclampsia occurred at a median of 31 weeks (27–34). Of 12 patients, intra-uterine fetal death occurred in 8 and placenta abruption in 3. Only one patient presented with HELLP syndrome and one experienced arterial dissection. When compared to patients without pregnancy-related complications, patients with complicated pregnancies were younger at FMD diagnosis (43 vs. 52 yo, p < 0.000), had lower prevalence of multivessel FMD (30 vs. 45%, p = 0.037) and cerebrovascular FMD (16 vs. 52%, p < 0.001), but underwent more often renal revascularization (62 vs. 32%, p < 0.000). CONCLUSIONS:: The prevalence of pregnancy-related complications such as hypertension during pregnancy and preterm birth in the EIFR is high, probably related to severity of renal FMD. However, the prevalence of preeclampsia and other severe complications was low. Our findings emphasize the need to screen hypertensive women of childbearing age for FMD in order to ensure renal artery angioplasty before pregnancy if indicated and proper follow-up during pregnancy, without discouraging patients with FMD to consider pregnancy.