A 35-year-old gravida 4 para 3 presents with a fever and diarrhea in the setting of exposure to raw and unpasteurized foods. Symptoms are consistent with listeriosis and a local outbreak of Listeria monocytogenes is identified. The patient is managed inpatient with empiric high-dose amoxicillin for 14 days while awaiting blood culture results, along with fetal monitoring and supportive care to prevent dehydration and electrolyte imbalance. L. monocytogenes causes the clinical disease listeriosis and about 16% of cases occur in pregnant women. Increased susceptibility to listeriosis is partly due to reduced T cell immunity. Symptoms can range from asymptomatic to severe disease with neurological symptoms. Transplacental infection can occur with neonatal disease even in the absence of maternal symptoms. Maternal, perinatal, and neonatal morbidity and mortality are high. The best strategy is primary prevention by avoiding high-risk foods such as deli meat and soft cheeses, along with raw and unpasteurized foods. Safe food storage and preparation techniques also have a role in decreasing infection from cross contamination. Individual decision-making and a discussion of risks should guide individual food related decisions.