BACKGROUND: Left ventricular assist devices have become increasingly common for the treatment of acute and chronic heart failure. It is unclear whether these devices can handle the increased stresses caused by pregnancy. CASE: An 18-year-old woman received a left ventricular assist device after peripartum cardiomyopathy. The patient was not adherent to prescribed medical regimens until she returned 11 months later, at 33 weeks of gestation. She underwent anticoagulation and inpatient surveillance until a cesarean delivery at approximately 34 weeks (based on ultrasound estimates). CONCLUSION: Left ventricular assist devices are allowing patients to live with minimal symptoms of heart failure and return to a good quality of life.