Cases of pregnancy-associated severe aplastic anemia (SAA) have been reported in the literature with historically high rates of mortality. We report the case of a 17-year-old female diagnosed with SAA at 26 weeks of gestation. She experienced intrauterine fetal demise and did not achieve hematologic remission after delivery. She received a histocompatible sibling donor bone marrow transplant 7 weeks after her diagnosis and remains in remission, at 1-year posttransplant. We review available literature and suggest that when a histocompatible sibling donor is available, bone marrow transplantation should be considered as a first-line therapy for patients with pregnancy-associated SAA.