Rheumatic autoimmune diseases are chronic conditions affecting multiple systems, predominantly occurring in young women of childbearing age. Given the nature of diseases and unique physiological changes during pregnancy, they may adversely impact pregnancy outcomes and endanger maternal and fetal health. In recent years, with the deepening of immunological research, biologically targeted therapy has gradually become a focus of attention in the treatment of rheumatic autoimmune diseases in pregnancy. Biologics effectively alleviate disease symptoms, mitigate pregnancy complications, and improve adverse pregnancy outcomes by targeting pivotal inflammatory factors. The review systematically discusses the structure and pharmacokinetic characteristics of biologics, and comprehensively reviews the current application and future prospects in managing rheumatic autoimmune diseases in pregnancy based on their specific targets. It aims to provide scientific references and guidance on the safe administration of medications and therapeutic strategies for these patients, ultimately enhancing health outcomes for mothers and infants.