Experts review updates in the field for the prognostication and management of intrahepatic cholestasis of pregnancy (ICP). Speakers lead a case-based discussion about challenging ICP cases and share approaches to management from ursodiol to ileal bile acid transporter (IBAT) inhibitor treatment. Topics include the association of chronic liver disease—including primary biliary cholangitis, hepatitis C, autoimmune liver disease, and cirrhosis—with the development of ICP, and the relevance of genetic testing for individuals with ICP.