The annual Gerard W. Ostheimer lecture aims to update Society of Obstetric Anesthesia and Perinatology members on the relevant literature published in the preceding year. In this lecture, papers from the anesthesiology, obstetric, perinatology, neonatology, and health services literature published between January and December 2020 were evaluated and selected based on significance and relevance to clinicians and scientists. There were over 2000 articles in 90 medical journals that met this initial screening criteria for review.