The LCMS affirms the literal, biological virgin birth of Jesus Christ—that Mary conceived and bore Jesus without a human father, and that the Holy Spirit was the agent of this conception. This doctrine is grounded in Scripture (Matthew 1:18-25; Luke 1:26-38) and is affirmed as a historical reality, not merely a theological symbol or pious legend.

However, the LCMS does not affirm the doctrine of Mary's perpetual virginity—the claim that Mary never had other children after Jesus. The LCMS teaches that Mary had other children with Joseph after Jesus' birth, as suggested by biblical references to Jesus' siblings (Matthew 13:55-56; Mark 6:3). While Mary is honored as the virgin mother of our Lord and is accorded special respect, she is not venerated as divine or co-redemptrix.

The virgin birth of Jesus is held to be essential to Christian faith, demonstrating that Jesus is truly the God-man, that his birth was a miraculous divine act, and that he came into the world without inheriting the guilt of Adam's sin. However, Mary herself is not regarded as immaculate or sinless, and the LCMS rejects the Roman Catholic dogmas concerning Mary's assumption and immaculate conception.