This chapter reviews the empirical literature on the effects of temperature and climate change on human pregnancies. The focus is on quasi-experimental studies that use panel data, apply a fixed effect approach, and exploit the random year-to-year fluctuation in temperature. The insights that emerge from the review highlight that exposure to heat in the preconception period exerts detrimental effects on fertility. In addition, heat exposure during pregnancy increases pregnancy losses, leads to a reduction in gestational length, and lowers birth weight. Despite the increasing empirical evidence on the subject, understanding the relationship between temperature and pregnancy-related outcomes is far from perfect. Importantly, the potential effects of climate change are rarely quantified. The chapter outlines directions for future research.