OBJECTIVE The goal of this review is to elucidate what is known about the science of maternal resuscitation and how treatment guidelines have developed to optimize management. RESULTS There is limited data on maternal cardiac arrest. Case reports are providing some insight into safety and efficacy of certain mechanisms of treatment, including use of extracorporeal membranous oxygenation and thrombolysis, for example. Data increasingly supports the preventability of a significant portion of maternal cardiac arrest, which remains the most important target for intervention. maternal cardiac arrest has increased in incidence over the past several decades but remains a rare event. In recent years, guidelines have emerged in attempt to standardize treatment, although research on best practice is scarce. Ultimately, future progress in targeting the rise in rate of cardiac arrest will come from large scale collaboration in data sharing and development of mechanisms to identify at risk patients to prevent arrest.