Systemic lupus erythematosus (SLE) is an autoimmune disease that mainly affects women of childbearing age and causes inflammatory damage to several organs. Telitacicept is a biologic drug that was first approved in China in 2021 for the treatment of active SLE, but its safety during pregnancy has not been well documented. This case report describes a 25-year-old woman with SLE who was exposed to telitacicept in early pregnancy—her last dose was given on November 4, 2024, and the pregnancy was confirmed shortly thereafter, on November 7, 2024. After the pregnancy was discovered, telitacicept was discontinued and the patient received oral glucocorticoids, hydroxychloroquine, and tacrolimus during pregnancy. On June 23, 2025, at 32 weeks gestation, she underwent a caesarean section due to intrauterine growth restriction and preeclampsia and gave birth to a son without any physical defects. This case suggests that exposure to telitacicept in early pregnancy did not result in structural abnormalities in this case, although further data are needed to determine the safety of this drug during pregnancy.