Peripartum cardiomyopathy (PPCM) is a rare form of heart failure which affects healthy young women with devastating consequences. The risk factors include older maternal age, multiparity, multiple gestations and black race. Peripartum cardiomyopathy is considered as a distinct entity as the incidence is higher than the incidence of idiopathic dilated cardiomyopathy (DCM) unmasked by pregnancy. The exact etiology is not known but various factors have been proposed which include myocarditis, abnormal immune response to pregnancy, and stress-activated cytokines. Recently, there have been reports of familial cardiomyopathy being unmasked by pregnancy. Clinical presentation, management, natural history and prognosis are presented.