Abstract: Puerperal sepsis is the leading cause of direct maternal mortality in the United Kingdom. In recent years, efforts have been made to increase awareness and reduce the burden of sepsis in pregnancy. We report the case of a 29-year-old Pakistani lady admitted to a London hospital at 37 + 3 weeks’ gestation with signs of infection and fetal distress. She had an emergency cesarean delivery and was treated for presumed chorioamnionitis. In the early postpartum period, she had a rapid deterioration exhibiting signs of septic shock. As part of her investigations, a blood smear demonstrated Plasmodium vivax parasitemia. Plasmodium falciparum is well documented as causing severe illness in pregnancy, whereas P vivax is often considered a benign form of malaria. The complex manifestation seen in this case reinforces the changing opinion of P vivax and its implications in pregnancy. It is prudent for physicians outside of endemic areas to remain vigilant of imported malaria.