INTRODUCTION:: The management of amniotic fluid embolism and maternal cardiac arrest requires coordinated time-sensitive teamwork skills. The study objective was to determine the effectiveness of teaching amniotic fluid embolism and maternal cardiac arrest management to residents using simulation. METHODS:: Obstetrics and gynecology residents received instruction using a highly interactive team-based simulation curriculum for the management of amniotic fluid embolism and maternal cardiac arrest with perimortem Cesarean-Section. The curriculum consisted of a didactic session followed by high-fidelity simulations of two scenarios. A 21-point checklist was used for baseline teamwork performance assessments. Outcomes were measured using pre-post knowledge tests and confidence surveys in the management of obstetrical respiratory emergencies. Paired t-tests and repeated measures were used for data analysis. RESULTS:: Twenty-one residents participated in the four-hour curriculum. Mean pre-post knowledge test scores demonstrated statistically significant improvement (75.0%, 94%, p less than 0.0001). Mean pre-post confidence levels rose in the management of amniotic fluid embolus (52.33%, 78.33%, p less than 0.0001) and maternal cardiac arrest (56.0%, 81.67%, p less than 0.0001). Incidentally, residents involved in the simulation curriculum experienced a real life maternal cardiac arrest with perimortem Cesarean-Section the same afternoon and commented that their experience in simulation contributed to the clinical outcome. CONCLUSION:: Training in both amniotic fluid embolism and maternal cardiac arrest with perimortem Cesarean-Section management is essential for obstetrical providers. Interactive team-based simulation training of these events improves knowledge, performance and confidence even when exposure to real-life obstetrical respiratory emergencies is rare.