Pregnant women are more susceptible to influenza and pregnancy may enhance the severity of the illness. In this article, we reported a 37-year-old pregnant woman with ARDS related to severe influenza A (H1N1) virus infection. A 37-year-old pregnant woman at 36 weeks gestation was admitted to our ICU with rapidly worsening dyspnoea. She had tachycardia, tachypnoea and severe hypoxia (PaO2/FiO2=104). A diagnosis severe H1N1 infection-related ARDS was made and treated with oseltamivir, broad-spectrum antibiotics, bronchodilators and NIV. Her nasopharyngeal swab was positive for H1N1. One day later, her hypoxia remained severe, and she was intubated and MV was commenced. Simultaneously, the patient gave birth to a healthy boy by emergency cesarean delivery. Her condition gradually improved. Pregnant women with severe H1N1 infection-related ARDS may be successfully treated with oseltamivir and mechanical ventilation.