Pregnancy following heart transplant (HT) surgery poses a high risk to the patient, and limited data are available on practices for post-HT pregnant patients. We report a case of a 34-year-old female patient in her 20th week of pregnancy, diagnosed with restrictive cardiomyopathy at 20 years of age. An HT procedure was performed 5 years ago on the patient. The patient had multiple miscarriages and in-vitro fertilization in 2021. The patient presented in the 20th week of gestation with shortness of breath and delivered prematurely via cesarean section. The procedure was successfully performed under spinal anesthesia with no complications, and the patient was stable. Implementing a multidisciplinary team in managing such challenging cases would further improve anesthesia management in the future.