Cardiovascular collapse during cesarean delivery is a rare entity that exposes the anesthesiologist to a crisis which presents a wide variety of possible causal agents, being the most relevant peripartum hemorrhage, peripartum cardiomyopathy, pulmonary thromboembolism, and high spinal anesthesia. We present a clinical case of a patient undergoing an emergency caesarean section for fetal compromise, in which, after the administration of neuraxial anesthesia, she presented severe hemodynamic compromise that did not respond to the initial maneuvers of volume expansion and administration of vasopressors and inotropes. Given the regular response to these maneuvers, a transthoracic echocardiography was performed, which revealed a pericardial effusion as the etiology of the maternal collapse.