Q fever is a widespread zoonotic infection caused by Coxiella burnetii. During acute infection, three clinical patterns are commonly encountered—self limited, flu like disease, atypical pneumonia or hepatits. Chronic infection almost always implies endocarditis. Acute infection during pregnancy may result in obstetrical complications, and predispose to chronic transformation. Treatment during pregnancy is more complex, and the duration of treatment was debatable up until recently. We describe a 31 years old patient with acute Q fever infection during pregnancy. We review the medical treatment, complications and follow up of acute and chronic Q fever during pregnancy.