A 16 year old Chinese female with puerperal ovarian vein thrombophlebitis following uneventful vaginal delivery is reported. This infrequent, but potentially fatal, complication in the febrile postpartum patient may present as a surgical emergency. Non-invasive diagnostic procedures and conservative treatment with heparinization and antibiotics have been suggested. However, early exploratory laparotomy for ovarian vein or caval ligation may be life-saving if the diagnosis is in doubt or the response to conservative treatment is unsuccessful.