Recurrent pregnancy loss is one of the main manifestations of antiphospholipid (Hughes) syndrome (APS). Fetal deaths (beyond the 10th week of gestation) are the most typical obstetric complication of APS. Data from controlled therapeutic trials are difficult to analyse, due to small samples and great heterogeneity in the obstetric history and antiphospholipid antibody profiles of women included. Corticosteroids are more harmful than beneficial. Heparin and aspirin are the drugs of choice for APS-related miscarriage, although it is not clear whether combination of both drugs is necessary for all women. The role of immunoglobulins is not well defined.