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Introduction: During pregnancy, there are changes in all systems of the human body, along with anatomical changes. It is common for women to decrease the intensity of physical activities, especially in the last trimester. Water activities during pregnancy have shown positive effects for this population. To review the effects of functional exercises in the aquatic environment for women during pregnancy. Methods: Systematic review using the PICO methodology, searched on the Pubmed, SciELO, LILACS, and Science Direct platforms, using the descriptors: Pregnancy, hydrotherapy, quality of life, pregnant women, and aquatic environment. Published randomized controlled trials that addressed the functional effects of aquatic exercise in pregnant women, published in English, Spanish, and Portuguese in the years 2010 to 2020 were included. In addition, the Boolean operators "and" and "or" were used. The research was conducted from May to July 2020. Results: The search initially resulted in 537 articles, of which 95 records remained after removing duplicates, 14 after reading abstracts and titles, and 5 articles were included in the end. The samples ranged from 46 to 140 participants. Of the five studies selected, all obtained positive results, including pain reduction during pregnancy, as well as improved weight control, blood pressure, and sleep quality. Conclusion: The practice of aquatic exercise for pregnant women acts positively in weight control, improves sleep quality, controls blood pressure, and decreases low back and joint pain. [ABSTRACT FROM AUTHOR]