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A 22-year-old woman, a known case of macroprolactinoma, was under good control with bromocriptine therapy. Bromocriptine was stopped as pregnancy was diagnosed and serum prolactine level was <20 ng/ml. She was under regular neuroendocrinal and gynecological evaluation. In twentieth week of her pregnancy she presented with headache and vision loss. Rest of her CNS examination was normal. Serum prolactine level was 250.0 ng/ ml. MRI of the brain showed pituitary apoplexy and compression over optic nerve and chiasma [Figure 1A C]. Ultrasonography of abdomen and pelvis was done and fetal well being was assessed. The patient underwent standard transsphenoidal decompression of gland and removal of hematoma. She had relief of headache and restoration of normal vision postoperatively