Nicotine replacement therapy (NRT) is effective for smoking cessation, but much controversy surrounds its use during pregnancy. The importance of finding ways to help pregnant smokers quit is undisputed, since smoking during pregnancy causes harm to the mother and the fetus, with effects of smoke exposure extending into childhood. Researchers and providers are divided, however, with respect to opinions of safety and efficacy of NRT use in pregnant smokers. The research-based evidence on the topic is limited, but there are studies examining the efficacy of NRT in pregnancy. This article presents the evidence for this smoking cessation methodology in pregnancy.