A 40-year-old at 39 weeks complains of acute onset of chest pain radiating into her jaw and becomes unconscious during the second stage of labor. The patient experiences cardiac arrest. In this case we review basic and advanced cardiac life support principles with a focus on the special circumstance of pregnancy and appropriate techniques. Leftward displacement of the uterus, evacuation of the uterus by 5 minutes of cardiopulmonary resuscitation, and early advanced airway are reviewed as features unique to maternal resuscitation efforts. We review physiologic changes unique to pregnancy, with a focus on cardiac, vascular, and respiratory changes that impact risks and appropriate methods for resuscitation. Risk factors such as underlying heart disease and obesity are reviewed. Identification of patients at risk for heart disease in pregnancy, including identifying subtle signs and symptoms that may alert healthcare providers earlier in pregnancy, are also reviewed. Potential diagnoses and underlying conditions are reviewed. Appropriate considerations for postresuscitation care, including a multidisciplinary approach in an intensive care unit setting, are discussed. Finally, opportunities for continued education and training in the management of obstetric emergencies, including cardiac arrest, are also reviewed in this case.