Hypercalcaemia affects 0.3% of pregnancies and is a serious medical complication in pregnancy requiring specialist endocrine input (1). Maternal complications include hypertension, preeclampsia, nephrolithiasis and acute kidney injury. Foetal complications include intrauterine growth restriction, preterm delivery, neonatal hypocalcaemia and hypoparathyroidism, and foetal death in utero (2). We present 3 cases of hypercalcaemia within our tertiary hospital. Case 1 comprises a 30-year old primiparous female with known primary hyperparathyroidism who presented at 33 weeks gestation with a serum corrected calcium (CCa) of 3.16mmol/L. At presentation, she described x and z. She was managed with intravenous fluids and frusemide. Commiserate with her wishes, she underwent normal vaginal birth at full-term and delivered a healthy neonate with minimal complications. Case 2 describes a 34-year old primiparous female who presented in the first trimester of an IVF pregnancy with mild asymptomatic hypercalcaemia, CCa 2.6mmol/L. Prior extensive investigations including bilateral neck exploration and resection of a suspected culprit lesion failed to correct hypercalcaemia. A tentative diagnosis of familial hypocalciuric hypercalcaemia (FHH) was made and subsequently confirmed on genetic testing. Finally, Case 3 describes a 33-year old female who presented at 29 weeks gestation of her third pregnancy with rapidly progressive, debilitating back pain. MRI scan demonstrated extensive metastatic disease within the spine associated with pathological fractures. Importantly, she had known BRCA 2 genetic mutation and had undergone bilateral prophylactic mastectomy 4 years prior, following the detection of ductal carcinoma in situ. She had PTH independent hypercalcaemia (CCa 3.36mmol/L, PTH <4.0pmol/L) with an elevated PTH-related Peptide (PTHrP) level of 2.1pmol/L. Acute management comprised intravenous fluids, frusemide and calcitonin prior to caesarean section at 32 weeks gestation The pregnant state imposes limitations in treatment options, since antiresorptive agents are contraindicated in pregnancy(3). Our cases highlight the varied presentations, aetiologies and acute management of hypercalcaemia in pregnancy(4).