Eclampsia, or toxemia of pregnancy, is a disorder of pregnancy characterized by seizures associated with hypertension, edema, and proteinuria. Toxemia of pregnancy carries significant maternal and fetal morbidity and mortality. Eclampsia most commonly occurs in the antepartum period. A minority of cases, however, may initially manifest in the postpartum period. We present the case of a 28-year-old female with postpartum eclampsia presenting to the Emergency Department with altered mental status. A review of the literature concerning postpartum toxemia and a discussion of appropriate management strategies follows.