Cardiovascular disease is the leading cause of death in pregnancy and the postpartum period, accounting for 25.6% of all US pregnancy-related deaths. While maternal cardiac arrest is a rare event, it is increasing in frequency and disproportionately affects non-Hispanic Black women. During cardiac arrest, advanced cardiac life support should be performed supine with left uterine displacement. Cardiac arrest in pregnancy is otherwise treated with the same ratio of chest compressions to breaths, respiratory support, drugs, and defibrillation as for any adult in cardiac arrest. Perimortem cesarean delivery (PMCD) should be considered if the uterus is at or above the umbilicus, causing aortocaval compression. While completing PMCD within 4–5 minutes of arrest provides the best maternal and fetal outcomes, completion well beyond the ideal timeframe may also provide benefit. It should occur regardless of fetal status or maternal location.