The National Transplantation Pregnancy Registry (NTPR) was established in 1991 to study the outcomes of pregnancies in female transplant recipients as well as pregnancies fathered by male transplant recipients. Data from the NTPR along with publications of smaller experiences have endorsed the concepts that successful pregnancies are possible in the solid-organ transplant population. The largest cohort among the organ transplant population studied by the NTPR continues to be the kidney transplant recipient group. Data collected over the last twenty years by the NTPR have addressed a myriad of issues, thus providing a variety of additional information for healthcare providers in caring for transplant recipients of childbearing age. Preconception guidelines proposed in 1976 have undergone some refinement over the years, however most remain applicable today. Outcomes of the children of transplant recipients have been encouraging with few negative effects identified, but ongoing surveillance is still important. This article will provide a review of the historical literature regarding pregnancy in the kidney transplant population, recent studies conducted by the NTPR, and a brief review of the current literature regarding pregnancy after kidney transplantation.