Pyogenic granuloma is a benign growth characterized by active vascular proliferation and is prone to occurring during pregnancy. Given the complicated conditions of this special group of patients, it is controversial to perform removal therapy before delivery. Here, two giant pregnancy pyogenic granulomas of a patient at 34 weeks gestation were safely, completely and minimally invasively removed by water-cooled Nd: YAG laser without anesthetic agents, suturing or antibiotics. No recurrence was observed after 1 year. This removal therapy immediately relieved the problem of patient nutrition intake and greatly improved the quality of her prenatal preparation. Thus, this report highlights that complete excision of pyogenic granulomas during pregnancy can be performed before delivery when urgent circumstances are considered, and a water-cooled Nd: YAG laser can be applied as a powerful tool in this treatment.