A 29-year-old pregnant woman sustained blunt, left lower abdominal trauma, with hip and pelvic fractures, and progressive dissection of an intimal flap in the left iliac artery, which manifested two days later as profound ischemia of the left leg. The patient underwent distal thromboembolectomy, fasciotomies and revascularization of the leg by femorofemoral polytetrafluoroethylene bypass. The patient recovered completely and gave normal birth three months later to a healthy child. Four years after the operation she gave uneventful birth to another child. Various considerations pertinent to this complex traumatic-vascular-gestational state are discussed.