The adhesion of cells to each other, to other cell types and to the extracellular matrix (ECM) is a crucial part of development and relies on the expression of cell adhesion molecules (CAMs) and their ligands. For example, at implantation, the trophoectoderm attaches to the uterine epithelial surface and CAMs play a major role in this process. Following attachment, interstitial and intravascular invasion of maternal tissue by trophoblast is required to develop the maternal-placental-fetal circulation and this too requires a new repertoire of CAM expression. Understanding the part played by adhesion molecules in pregnancy is paramount because several pregnancy associated disorders including pre-eclampsia, fetal growth retardation, miscarriage and infertility problems have been linked to abnormalities in expression of particular CAMs and/or their ligands. The aim of this article is to review the major CAM families and their role in human pregnancy. Excellent reviews which include reference to animal studies can be found elsewhere.