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Pemphigus is a group of immune-mediated bullous disorders that often cause fragile blisters and extensive lesions of the skin or mucous membranes. A rare clinical situation, pemphigus during pregnancy may have an impact on the health of the mother and the fetus. Being an autoimmune disease with dominant T Helper 2 cells activity, pemphigus is expected to flare in pregnancy, especially in the first two trimesters. Objective: To detail the presentation, course and complications in pregnancy with management strategies. Methods: Case report of a 20-year-old lady who presented in the 3rd trimester of pregnancy with post-treatment outcome. Observations: The decision-making and management process incorporated a diverse team approach which included Dermatology, Obstetrics, Endocrinology, Anaesthesia and Neonatology. The patient was diagnosed after careful clinical examination, skin biopsy and Direct Immunofluorescence positivity. Although she presented in her 3rd trimester with skin lesions with secondary infection for further management, she developed steroid-intake related complications like hyperglycaemia, hypertension and subsequently severe preeclampsia and fetal growth restriction, resulting in an operative preterm delivery. Postnatally, she developed hypertensive emergency with pulmonary edema, resulting in prolonged hospitalisation. Conclusion: Although Pemphigus vulgaris in pregnancy is extremely rare, customized treatment options and care plans with a multidisciplinary approach can improve maternal and fetal outcomes.