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Cardiothoracic involvement by obstetric and gynecologic pathologic conditions creates a broad spectrum of clinical and radiologic manifestations, ranging from mild to critical. The authors describe the unique and often unrecognized or unexpected imaging manifestations of obstetric and gynecologic conditions in the chest. Pregnant, peripartum, and postpartum patients experience varied disorders, including eclampsia/preeclampsia, pulmonary edema, pneumonia, aspiration, acute respiratory distress syndrome, thromboembolism, other forms of embolic disease, cardiomyopathy, and metastatic gestational trophoblastic disease. Appropriate methods of imaging pregnant patients are also discussed. Gynecologic malignancies develop characteristic patterns of thoracic involvement related to the pathways of tumor spread and underlying histopathologic tumor features. Laboratory biomarkers add diagnostic value to imaging interpretation in this setting. Benign forms of gynecologic disease manifest in the chest as Meigs syndrome, thoracic endometriosis syndrome, and intravascular or metastasizing leiomyomatosis. To facilitate accurate and timely radiologic diagnosis, the authors provide a comprehensive overview of cardiothoracic imaging findings associated with benign and malignant obstetric and gynecologic conditions. ^©RSNA, 2026 Supplemental material is available for this article.