This article reports a 33-year-old woman with persistent active acromegaly following transsphenoidal pituitary surgery who was treated with octreotide long-acting release (LAR) for 4 months and then became pregnant. Octreotide LAR was stopped at the diagnosis of pregnancy. Throughout pregnancy, the patient experienced clinical well-being, and regression of skin thickening and enlargement of extremities. Glucose tolerance was normal and serum IGF-I concentrations remained within the normal range of nonpregnant women at 3, 6, and 9 months. The patient delivered a healthy newborn following an uneventful pregnancy. Postnatal development was normal. Serum IGF-I levels increased progressively after delivery and 3 months later reached prepregnancy levels. The literature on somatostatin analog therapy in women with acromegaly before or during pregnancy is reviewed. This report illustrates an unusual pattern of persistently normal IGF-I during the pregnancy without octreotide therapy, followed by a subsequent rise in the postpartum period.