Acute Pulmonary Edema (APE) is a condition affecting about 0.08-1.5 % of women during pregnancy and puerperium, accounting for 2.5-3.0 % of admission to obstetric ICU, constituting 9.8-11.5% of all patients of ‘maternal near miss’ criteria. This study was conducted across 3 tertiary care centres of Haryana, North India, to evaluate cases of APE in obstetrics ICU. 50 patients had acute pulmonary edema in the study period, with mean age 26.2 years, 60% were from rural setup, 76% were primigravidae, 56% had antepartum APE, 36% post partum and 2% intra partum, 8% had previous history of Pre-Eclampsia, 10 % relapsed during hospital stay, 4 % mortality rate. 80% had caesarean delivery, 76 % delivering preterm (<37 weeks gestational age), 40% were <34 weeks gestational age. Etiological causes – 64 % hypertensive, cardiogenic (16%) both cardiogenic & hypertensive (20%), fluid overload (2 %) irrespective of underlying etiology , 30% had fluid overload in the 24 hours preceding the acute PE event. Medium time from diagnosis to resuscitation was 5 minutes (within 25 min of diagnosis in 80 % of patients) Mean ICU stay was 6 days and hospital time was 13 days. APE is a medical emergency resulting in high maternal mortality rate (MMR). Most commonly occurring ante-partum period, with a hypertensive background and fluid overload being an important trigger.