Background: Although iron is the second most common overdose agent in pregnancy, the obstetric literature does not reflect current management of this emergency. Case: A 27-year-old woman, para 0-3-4-3, at 27 weeks' gestation ingested 24 mg/kg of elemental iron in a suicide attempt. Therapy with crystalloid hydration, gastric lavage, and intravenous deferoxamine chelation treated the overdose without maternal or fetal complications. Conclusion: Pregnancy should not alter therapy for acute iron overdose. Deferoxamine administered in the third trimester is not associated with perinatal complications and is potentially life saving.