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: BackgroundAmniotic fluid embolism is a rare yet often lethal peripartum complication resulting from rapid cardiovascular collapse. Progress toward a better understanding of this entity has failed to identify either the underlying hemodynamic pathophysiology or an effective evidence-based treatment.: CaseA 45-year-old woman with a documented placenta previa experienced an amniotic fluid embolism during scheduled cesarean delivery. Transesophageal echocardiogram examination revealed catastrophic pulmonary vasoconstriction. The use of cardiopulmonary bypass, heparin, epinephrine, and high-dose steroids resulted in a successful outcome.: ConclusionTimely placement of transesophageal echocardiogram revealed catastrophic pulmonary vasoconstriction as the cause of circulatory collapse in a patient with amniotic fluid embolism, supporting the use of cardiopulmonary bypass as an effective intervention. [Copyright &y& Elsevier]