Abstract: Objective To investigate the clinical management and anesthesia management experience of cerebrovascular disease during pregnancy and puerperium. Methods To retrospectively analyze the clinical data, anesthesia management and outcome of 62 pregnant women and puerperium with cerebrovascular disease from June 2010 to December 2017 in Beijing Tiantan Capital Medical University. Results A total of 62 cases of pregnancy and puerperium with cerebrovascular disease were collected, including 23 cases of ischemic cerebrovascular disease: 1 case of TIA, 8 cases of cerebral infarction, 14 cases of sinus thrombosis; 39 cases of hemorrhagic cerebrovascular disease: 5 cases of aneurysms, 12 cases of arteriovenous malformations, 5 cases of cavernous vascular malformation, 4 cases of moyamoya, 1 case of preeclampsia, other 12 cases of cerebral parenchymal hemorrhage. 24 cases were treated by neurosurgery and 38 cases were treated by conservative treatment. Obstetric anesthesia types include14 cases of spinal anesthesia and 14 cases of general anesthesia. There were 7 cases of maternal vegetative state or death and 9 cases of fetal / infant death. 30 patients underwent cesarean section before neurosurgery, including 17 cases of spinal anesthesia and 13 cases of general anesthesia. Conclusions The management of cerebrovascular diseases in pregnancy and puerperium should be closely coordinated and managed by obstetrics, anesthesia and neurosurgeons. The factors of cerebrovascular disease, gestational age and fetal maturity, as well as the wishes of pregnancy should be fully evaluated to timely terminate pregnancy and neurosurgical treatment and improve maternal fetal outcome.