Information on the association of erysipelas with pregnancy is rare. A 32-year-old woman, para 3, gravida 7, six weeks before her expected date of delivery noted a slight swelling over the right cheek. It persisted, and she was treated with ACTH and diphenhydramine hydrochloride. Several days later she was hospitalized with edema, erythema, induration of the face and neck, and a temperature of 38.6 C (101.5 F). Chlortetracycline and meperidine hydrochloride were included in therapy. Cultures disclosed hemolytic streptococci. The disease process extended to the upper one-fourth of the chest, and therapy with erythromycin was started. A living girl in good condition was delivered. Several hours later blood pressure had dropped to 84/70 mm. Hg. Whole blood, hydrocortisone, lanatoside C, streptomycin, and levarterenol bitartrate were given, but the patient became cyanotic and died. The anatomic diagnosis was erysipelas with acute cellulitis of the face, neck, and chest; acute mediastinitis involving the pericardium and pleurae with pleural effusion; and acute congestion of the viscera. Pregnancy undoubtedly was a factor in the outcome.