Pregnancy is a time of great joy, excitement and anticipation for most women. Unfortunately, for many it can also be a time of serious problem, even for women who have never had problems. Chronic diseases represent a major problem and public health burden in developing countries. It represents 73.0% of mortality and 60.0% of global morbidity burden. In Egypt about 26.0% of all deaths related to chronic diseases. Its risk comes higher during pregnancy. Aim: the current study aimed to describe pregnancy related anxiety among chronically ill women. Design: Descriptive research design was used to achieve the aim of this study. Setting: This study was conducted at antenatal outpatient unit at Mansoura University Hospital in Mansoura city over a period of five months started on July 2017 & finished on November 2017. Subjects: A purposive sample was used to select sixty five pregnant women with chronic illness. Tools: two tools were used for data collection; the first tool was Structured Interviewing Questionnaire. General characteristics, the past and present Obstetrical history, and the chronic condition during pregnancy. Tool two was Pregnancy-Related Anxiety Questionnaire–Revised (PRAQ-R2). The PRAQ-R2 is composed of 11 items that are used to assess and identify pregnancy-specific anxiety in nulliparous and parous women. Results Slightly more than half of the women have DM. Nearly half of them experienced severe anxiety. More than two fifth of the studied women reported that they were afraid of giving birth. More than half of them were severely worries about bearing handicapped child, more than two fifths of them severely concerned by their own appearance. There were a highly significant relation between the anxiety level according to PRAQ-R2 and its three sub domains, number of children, level of education of the women, gestational age and women's duration of illness. Recommendations: Simple handouts as booklets and brochures about chronic diseases and anxiety pattern should be developed and distributed at antenatal clinics. Evidence-based anxiety and chronic disease care guidelines should be integrated in maternity courses curriculum for nursing students. Finally, anxiety management enhancing educational session should be applied at the maternity hospitals and centers .for health care provider