Acute myocardial infarction during pregnancy is a rare but potentially fatal complication. We describe a 43-year-old patient with non-ST-segment elevation myocardial infarction during late pregnancy. She underwent coronary angiography but was treated conservatively after an occlusion of mid-size left oblique marginal branch was observed. During pregnancy many medications normally used in the setting of acute coronary syndrome are contraindicated and use of radiation should be minimized. Thus treatment of acute coronary syndrome must be carefully tailored in this patient group.