Background Approximately 10% of women and 6% of men who become parents will experience mental health problems and a significant proportion of these have a severe psychiatric illness. Purpose This paper provides a literature review of the needs of parents with severe mental illness. Methods Literature review. Results Mothers with severe mental illness have a wide range of complex health and social care needs in addition to their parenting needs, which must be addressed by services in pregnancy and postpartum to optimise outcomes. There is limited evidence on the needs of fathers with severe mental illness but they may have a greater number of needs than women, and a greater need for training in parenting skills than women suffering from severe mental illness. Parents with severe mental illness may experience stigma and discrimination, and fear accessing services due to fears of losing custody of their child. Conclusions Although a significant proportion of parents with severe mental illness do lose custody, many can successfully parent if adequate support is available and needs are assessed and managed by a multi-disciplinary team.