Amniotic fluid embolism (AFE) is an obstetric emergency characterized by sudden onset hypoxia, hypotension, and coagulopathy. It results from an immune response that occurs after a breach of the maternal circulatory system by fetal material during pregnancy, labor, or postpartum. These rare events are often lethal as cardiovascular collapse occurs rapidly. Massive amounts of pulmonary vasoconstrictors are released, which results in respiratory and right heart failure followed quickly by left heart failure, cardiogenic pulmonary edema, and hypotension. Interventions are supportive with the use of respiratory support, vasopressors, and inotropes. Disseminated intravascular coagulation (DIC) worsens the hemodynamic instability and the use of massive transfusion protocol is typically needed to correct the DIC. Prompt suspicion, rapid assembly of a multidisciplinary team that includes critical care experts, and immediate supportive intervention improves outcomes.