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Background: Hypereosinophilic syndrome is defined as the sustained overproduction of eosinophils leading to the dysfunction of one or more organs. Most of the deaths associated with Hypereosinophilic syndrome are related to cardiac involvement.

Case Presentation: We present the case of a 32-year-old woman who became pregnant during her follow-up period for her diagnosis of HES with cardiac involvement. She was treated successfully with a combination of IFN-alfa and prednisolone. She underwent an elective C-section at 39 weeks and delivered a healthy infant weighing 3400g. The patient died due to a complicated intra-abdominal infection secondary to colon perforation at 8 years of illness and 4 years of giving birth.

Conclusion: We reviewed the literature on the best treatment modalities for this challenging issue. Management of idiopathic HES causing severe heart failure during pregnancy can be achieved using steroids and interferon-α.