A 40-year-old G3P2 at 18w2d presented with fever and vaginal discharge one day before a scheduled D&E for spontaneous abortion. Following induction of general anesthesia and a paracervical block with lidocaine, pulseless ventricular tachycardia developed. Local anesthetic systemic toxicity (LAST) was suspected, and 20% lipid emulsion bolus and infusion were administered during resuscitation, restoring circulation. Subsequently, heavy uterine bleeding and thromboelastogram findings consistent with DIC suggested amniotic fluid embolism (AFE). CT angiography later revealed small pulmonary emboli. After transfusion, coagulation normalized and the patient was extubated the same day. Experimental data support lipid emulsion’s protective vascular effects in AFE.