Chocolate cysts have no direct effect on the fetus, but if the cysts gradually increase in size during pregnancy or even rupture, they are prone to increase the risk of miscarriage and preterm labor. Chocolate cysts are a common manifestation of endometriosis, mainly manifested as medium-sized cysts in the ovaries. Since the contents of the cysts are usually in the form of coffee-colored mucus, they are commonly known as chocolate cysts, which are a serious threat to women’s health. Generally speaking, chocolate cysts during pregnancy do not directly affect the growth and development of the embryo. However, if a chocolate cyst ruptures or torsion occurs during pregnancy, it may cause acute abdominal pain. It can cause severe abdominal pain, fever, and contractions, which can lead to preterm labor or miscarriage and require timely surgery. In addition, patients with chocolate cysts need to undergo regular checkups during pregnancy, and seek timely medical attention if they experience any discomfort, in order to identify the specific cause of the disease and provide targeted treatment.