Severe maternal morbidity is frequently associated with catastrophic complications of pregnancy such as amniotic fluid embolism (AFE) or sepsis due to chorioamnionitis. The authors report a case of postpartum maternal hypoxic encephalopathy that might be attributed to AFE or sepsis due to chorioamnionitis with Escherichia coli bacteremia, and review the relevant literature. The patient presented with preterm labor, underwent Cesarean section for intrauterine fetal demise, and experienced postpartum cardiopulmonary collapse and disseminated intravascular coagulation, which led to catastrophic postpartum maternal encephalopathy.