Objective To understand the experiences of pregnancy and motherhood among women with congenital heart disease, and to provide reference for pregnancy management.Methods A systematic search of major Chinese and English language electronic biomedical literature databases was performed to retrieve qualitative studies on experiences of pregnancy and motherhood among women with congenital heart disease, from inception of the database to May 2024.The quality of the literature was evaluated according to the JBI critical appraisal checklist for qualitative research, and the similar results were summarized for more advanced synthesized findings.Results Six publications were included.Four synthesized findings were identified from 10 categories based on 21 original findings:complexity of factors influencing pregnancy decision-making, multiple pregnancy-related concerns, inexpe-rience with pregnancy and motherhood and high demand for professional guidance, growth and gains related to pregnancy.Conclusion The pregnancy decision-making in women with congenital heart disease is affected by multiple factors, leading to multi-dimensional worries and needs.Medical staff should pay attention to the pregnancy-related needs of patients, provide decision coaching to prepare patients for making decisions, and strengthen risk assessment and education.