Nicotine use during pregnancy remains a widespread problem in obstetrics, leading to complications such as intrauterine growth restriction, preterm birth, stillbirth, and sudden infant death syndrome. Consistent education by medical personnel is essential, as no medication or supplement has been found to prevent the dangers of nicotine use during pregnancy. If a pregnant woman is unable to quit nicotine despite intensive efforts, vitamin C, with its antioxidant properties, may help mitigate these risks, as suggested by some studies. This review summarizes current knowledge based on publications related to vitamin C, nicotine, and pregnancy. Research was conducted on the medical literature platforms PubMed and Cochrane Library, using all relevant studies to provide a comprehensive overview of the topic. The identified studies primarily examined the impact of maternal smoking and nicotine on placental function, as well as the respiratory, cardiac, neuronal, and bone systems of the offspring. They suggest that vitamin C has a generally positive preventive or protective effect, though no study has shown complete compensation for the damage caused by nicotine. Nicotine abstinence remains the most crucial preventive measure. If this is not achievable despite intensive efforts by medical personnel, vitamin C supplementation during pregnancy may be considered. With a very low side effect profile, a daily dose of up to 500 mg can be recommended. However, further studies are necessary to provide reliable data on the effectiveness and appropriate dosage, given an ethically justifiable study approach.