A 27 weeks' pregnant women exhibited infective endocarditis due to alpha-streptococcus. As echocardiography showed vegetations on both mitral leaflets, cesarean section was performed at 35 weeks' gestation and a healthy male infant weighing 2,430 g was delivered. Antibiotic therapy was continued for fever after the cesarean section but macrohematuria and Osler's nodes developed. Emergency mitral valve replacement was performed successfully despite the presence of active infective endocarditis. She was discharged after completion of a 10-week course of antibiotic therapy.