Intrahepatic cholestasis of pregnancy (ICP) is a gestational liver disease characterized by pruritus with abnormal bile acids and an increased risk for adverse fetal outcomes. The etiology is unclear, but it believed to have genetic, hormonal, and environmental components. Possible fetal complications include meconium staining of amniotic fluid, preterm labor, and unexplained sudden intrauterine demise. Researchers are currently investigating multiple different medications for the management of ICP. This article will review the epidemiology, clinical features, pregnancy complications, and treatment for ICP. Furthermore, this review will discuss current recommendations on the timing of delivery to mitigate possible fetal repercussions of this disease.