Hemolysis, elevated liver enzymes, and low platelet counts (HELLP) syndrome is one of the serious obstetric complications. The pathophysiology, diagnosis and treatment have not yet yet completely defined. HELLP syndrome usually develops during pregnancy and is associated with pregnancy-induced hypertension. In this case, a healthy multiparous woman having a normal gestational period and vaginal delivery developed massive postpartum bleeding with the suddenly progressive symptoms; hemorrhage, hemolysis, severely elevated liver enzymes, thrombocytopenia, acute renal failure, and pulmonary edemas. We report the case of anesthetic care for the patient with severe postpartum HELLP syndrome. The patient discharged without any severe complications 26 days after the surgery.