Varicella infection during pregnancy is associated with serious maternal and fetal complications such as congenital varicella syndrome, maternal pneumonia and neonatal varicella. Pregnant women are ineligible to receive the varicella vaccination, thus women who lack evidence of immunity to varicella are at an increased risk for developing a varicella infection if exposed to a contagious individual. Presently, post-exposure prophylaxis involves the administration of a varicella zoster immunoglobulin (VariZIG™) to prevent or reduce the severity of an infection. The US FDA recently approved VariZIG for licensure and recommend that it be administered as soon as possible following VZV exposure, ideally within 96 h for greatest effectiveness. The following review critically examines the role of VariZIG in post-exposure prophylaxis of varicella during pregnancy.