Many women affected by hidradenitis suppurativa (HS) are of childbearing age. To date, the literature is limited on pregnancy-related outcomes for women with HS. To investigate maternal and obstetric outcomes, and treatment utilization among women with HS. This retrospective analysis used the IBM MarketScan® Commercial Claims Database. Pregnant women with HS (n = 998) and 5:1 age-matched pregnant women without HS (n = 5,065) were identified and information on claims related to diagnoses, procedures and medications were analyzed. Compared to non-cases, pregnant women with HS had significantly lower odds of having livebirths (odds ratio (OR) = 0.45, [95% CI = 0.39-0.51]), and significantly higher odds of having elective terminations (OR = 2.51, [95% CI = 2.13-2.96]), gestational hypertension (OR = 1.44 [95% CI = 1.12-1.84]), cesarean deliveries (OR = 1.28, [95% CI = 1.06-1.55]), and receiving HS designated treatment during pregnancy (OR = 4.41, [95% CI = 3.56-5.46]).Retrospective and convenience sampling and absence of clinical information to correlate HS severity and outcomes. Pregnant women with HS have an increased probability of select complicated maternal and obstetric outcomes. Women planning for pregnancy or who are currently pregnant may benefit from coordinated care by dermatologists and obstetrical providers.