Gestational malaria is a life-threatening disease that affects pregnant women in endemic regions. Infection with parasites of the genus Plasmodium, transmitted by infected mosquitoes, can trigger complications for the mother and fetus. We present the description of a clinical case of gestational malaria complicated by Plasmodium vivax in a 25-year-old multiparous patient in the third trimester of pregnancy from an endemic area in the department of Córdoba, Colombia. Admission to the intensive care unit for 3 days and an emergency cesarean section were necessary due to serious complications, such as anemia, severe thrombocytopenia, and hypertensive symptoms. Treatment included the use of chloroquine and red blood cell and platelet transfusions to address hematologic complications. After the cesarean section, the patient made a satisfactory recovery and was prescribed primaquine for 14 days. The importance of surveillance and adequate management of gestational malaria is highlighted to prevent serious complications during pregnancy and in the postpartum period. This clinical case highlights the complexity of gestational malaria and the need for a comprehensive approach to its management, with special attention to hematologic, hypertensive, and obstetric complications that may arise in this clinical context.