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Spontaneous coronary artery dissection (SCAD) is a rare acute coronary artery event; however, it should always be considered in pregnant and postpartum patients as it can be life-threatening if untreated. Diagnosis of pregnancy-associated spontaneous coronary artery dissection (PSCAD) can be challenging when pathophysiological lines are blurred by changes related to pregnancy or concurrent obstetric processes such as pre-eclampsia or haemolysis elevated liver enzymes and low platelets. It has been reported that PSCAD has an increased incidence in women with pre-eclampsia, possibly due to their similar pathogenic mechanisms. We present a case of a woman who developed PSCAD on postpartum day 1 from an uncomplicated vaginal delivery. Her diagnosis was complicated by simultaneous elevation of blood pressures and worsening gestational thrombocytopaenia. The patient underwent coronary artery catheterisation, which confirmed the diagnosis of SCAD and was treated conservatively. She was eventually discharged home without any longstanding complications.