Many women per year expose ionizing radiation during pregnancy for medical reason (diagnostic or treatment). Ionizing radiation is known to cause harm on the human embryo and fetus. Potential adverse outcomes related to radiation exposure during pregnancy include teratogenicity, genetic damage, intrauterine death and increased risk of malignancy. Most diagnostic radiation procedures will lead to a fetal absorbed dose of less than 1 mGy (0.1 rad) for imaging not involving abdomen/pelvis, less than 50 mGy (5 rad) for involving abdomen/pelvis and less than 10 mGy (1 rad) for direct or nuclear medicine imaging. When a pregnant patient requires radiation therapy, the physician should consider fetal sensitivity to radiation in early gestational age and the expected dose of radiation and should then calculate the risk to the fetus versus the benefits to the mother. It is safest to administer radiotherapy during or after the 25th week of gestation. The use of radiation for diagnostic imaging or treatment in the pregnant woman is associated with a high level of anxiety for woman, her family and her doctors. This article reviews the biological effects of radiation on the fetus. Recommendations to take in to account when considering the safety of the fetus during a procedure are presented.