A 7 year old black and white Holstein cow presented to Cornell University’s emergency service with a 3 day history of inappetence, decreased milk production, foul vaginal discharge, and abdominal distention since calving. Problems on physical exam included: dehydration, right abdominal distention, right sided tympany, foul vaginal discharge, and a large fetus present in a large, fluid-filled uterus. Routine serum chemistry revealed hypocalcemia, hypochloremia, and alkalosis. Fluid obtained by abdominocentesis had elevated total protein concentration. Surgery was elected after stabilization of the patient. Fluids and antibiotics were administered and a C-section was performed using the ventrolateral approach. A large emphysematous fetus was removed. The cow became febrile 3 days after surgery, and her antibiotics were changed because of suspected peritonitis. She improved over the subsequent 3 days and was discharged. Her incision became infected after discharge but both her peritonitis and incisional infection resolved with prolonged antibiotic use on the farm.