A 31-year-old postpartum woman with history of gestational diabetes and preeclampsia developed thunderclap headache (TCH) after the birth of her first child. Vital signs were notable for systolic blood pressure up to 170 mm Hg. Neurologic examination results, including fundoscopy, were normal. There was no evidence of meningismus. Computerized topography (CT), CT angiography, and CT venography were normal for intracranial hemorrhage, aneurysm, dissection, or venous thrombosis. She presented 2 weeks later with multiple daily paroxysmal episodes of TCH lasting minutes. Further review of her history revealed similar episodes of recurrent TCH and palpitations approximately 1 year earlier.