Although primary Sjögren’s syndrome (SS) mainly affects women, its gynaecological, obstetric, and sexual aspects have been largely overlooked. Data regarding the impact of the disease on pregnancy and vice versa are scant. Primary SS can occur in all age groups but usually starts after the fifth decade, often beyond the childbearing age; however, at least in the Western world, the age of first pregnancy is increasingly delayed, so pregnancy in SS is being encountered more frequently. Vaginal dryness represents the main cause of dyspareunia, which seriously affects individuals’ quality of life, but data regarding this aspect of the disease are scarce. In this chapter we review the main gynaecologic complications of SS, focusing on their prevalence and impact on daily life. In addition we review pregnancy outcome in primary SS including obstetric complications, pregnancy outcome, and manifestations of neonatal lupus.