Vitamin E is an important lipophilic antioxidant. The term refers to eight essential naturally occurring fat-soluble nutrients called tocopherols or tocotrienols. Among these isomers, alpha-tocopherol has the highest biologically active form and is found in all lipoprotein fractions. Vitamin E deficiency during pregnancy may cause miscarriage, preterm birth, preeclampsia, and intrauterine growth restriction. This review highlights recent findings that have led to a better understanding of vitamin E absorption, transport, bioavailability, and its role in pregnancy, and that underline the need for re-evaluation of the potential benefits of vitamin E supplementation in pregnant women.