Aim The aim of the study was to investigate compliance with occupational health and safety (OHS) among pregnant surgeons. Methods All female surgeons in Saxony up to 45 years of age received a written questionnaire about their work environment during pregnancy. Predefined and expert-based criteria of OHS were analyzed descriptively. Poor compliance with OSH was defined as meeting a maximum of half of the criteria. Using logistic regression, professional factors (i. e. operating due to lack of staff) and personal factors (i. e. operating due to residency) were investigated for poor compliance with OSH. Results Of the participating female specialists, 55% (response=39%) had performed surgery during pregnancy. On average, 7.4 of the 16 occupational health and safety measures were fulfilled (median=8; range 1-13). In none of the cases were all predefined OSH criteria fulfilled. Two-thirds of the women who worked in non-operative areas took on invasive activities. When the women were working outside the operating theatre, an average of 4.1 of 13 predefined OSH criteria was fulfilled (median=4; range 0-8). Lack of staff was related to poor OSH compliance in the multivariate analysis (OR=5.9 (95% CI 1.7-20.0)). Conclusion The results of the study show a great need for improvement in the occupational safety of pregnant surgeons.