Introduction: Delusions of pregnancy are not often reported in geriatric patients and it is possible that they are psychogenetically explainable. Methods: Case report and non-systematic review of the relevant literature. Case presentation: A 78-year-old woman, diagnosed with paranoid schizophrenia, developed the delusion of being pregnant in a relapse of her disease. After this relapse, she and her husband got back together and the family was reunited again. The interpretation of this delusion was psychotherapeutically fruitful. Literature review: Psychogenesis is probably one of the central phenomena of psychopathology and delusions of pregnancy, surrounded by social and cultural factors of first order, are an example of such a pathogenetic mechanism. Conclusions: Delusions of pregnancy are frequently a type of psychogenic delusion. This causal phenomenon must be considered in the comprehensive approach to the psychotic patient.