Primary adrenal insufficiency is a rare disease which can lead to fatal outcomes when complicated in pregnancy. The vague symptoms such as nausea, fatigue and abdominal pain may interfere with its diagnosis. But once the diagnosis is made after a simple ACTH stimulation test, a successful pregnancy and delivery can be accomplished by replacement of steroids. It is to be noted that proper management in crises such as labor, delivery, operation and postpartum is very important. We report a case of successful delivery of a woman with primary adrenal insufficiency with a brief review of literature.