This chapter reflects on the symbolic pregnancy of Taoist adepts in Internal Alchemy (Neidan) on the basis of Taoist sources from the twelfth century to the twentieth century. The first part of the study considers the history and likely Buddhist origins of the pregnancy metaphor, along with its development in Taoism. In Buddhist texts, the notion of pregnancy is essentially used as a trope to express ideas pertaining to spiritual advancement, whereas in Taoist Internal Alchemy, its use also consists of an appropriation of the processes of life that govern the human book-body and the universe. The second part of the study examines variations in descriptions of the formation of the sagely embryo. These variations betray the difficulty of conceiving such a thing as male pregnancy, even if only symbolically. An ambiguous but still patriarchal discourse grounded in gender distinctions underlies significant differences between descriptions for male and female practitioners.