Idiopathic pulmonary hemosiderosis is a rare disorder that results in significant anemia and pulmonary compromise. The case of a patient with new onset of disease diagnosed during labor is presented, and after urgent cesarean delivery, both the neonate and the mother survived. The anesthetic implications of a parturient with idiopathic pulmonary hemosiderosis, including monitoring, preoperative evaluation, and perioperative care, are discussed.