Summary: The management of acute myeloid leukemia (AML) during pregnancy remains a clinical challenge for oncologists, obstetricians, patients and their families. Although the incidence of AML during pregnancy is low at 1 in 75,000 pregnancies, cancer is the second most common cause of maternal death behind pregnancy-related vascular complications. Due to the small number of patients diagnosed, there are only retrospective reviews and case series to guide complex management decisions. Case Report: A 35-year-old woman presented to our facility at 32 weeks' gestation after being found to have hyperleukocytosis, neutropenia, and anemia during a routine antenatal evaluation. Bone marrow aspiration demonstrated a diagnosis of AML. The blast population compromised 93% of the cellular elements.