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Pituitary adenomas usually cause damage to the gonadal axis, leading to a decrease in fertility in female patients. As pituitary gland enlarges during pregnancy, the hormone secretion of the gonadal axis changes accordingly. Therefore, it is particularly important to standardizedly manage pregnant women with pituitary adenomas. To this end, the European Society of Endocrinology (ESE) published Clinical Practice Guideline on Functioning and Non-functioning Pituitary Adenomas in Pregnancy in August 2021, which details the timing and methods selection of diagnosis and treatment of pituitary adenomas from preconception to postpartum in terms of size, location, and endocrine function of adenomas. We interpreted this guideline and summarized its main points, with a view to providing practical guidance for Chinese clinicians to manage such patients based on relevant clinical evidence and patient characteristics in China.