Acetaminophen (Paracetamol) is a common over-the-counter medication that has gained substantial media attention regarding its use by pregnant women. Although estimates vary considerably, most studies and surveys report that around 40–65% of women take acetaminophen sometime during their pregnancy. Historically considered safe, concern was initially raised back in 2014 with a JAMA Pediatrics publication stated that use in pregnancy lead to ADHD in the offspring. Seven years later, in 2021, a consensus statement published in Nature Reviews Endocrinology suggested that acetaminophen use in pregnancy might increase the risk of neurodevelopmental and urogenital tract abnormalities in offspring and called for “precautionary action”. This lead tgo an ACOG response back in Sep 29, 2021 (we will review). This is very controversial. Today, Dec 5, 2024, a new clinical perspective was published in Obstetrics & Gynecology adding another flavor to the mix. Is acetaminophen a direct cause of fetal harm? Listen in for details!