Shoulder dystocia is an obstetric emergency in which gentle downward traction of the fetal head does not lead to delivery of shoulder and additional obstetric maneuver are required to deliver the fetal shoulders. This can cause neonatal brachial plexus injuries, hypoxia and maternal trauma, including damage to the bladder, anal spinchter, rectum and postpartum haemorrhage. Although fetal macrosomia, prior shoulder dystocia,3 excessive weight gain during pregnancy, diabetes mellitus, advanced maternal age, prolonged 2nd stage of labor and oxytocine labor induction increase the risk of shoulder dystocia, most cases occur without warning.5 when shoulder dystocia occurs it should be vocally announcing that dystocia is happening, summoning extra assistance, keeping track of the time from delivery of the head to full delivery of the neonate, and communicating with the patient and health care team are helpful. calm and thoughtful use of maneuvers such as suprapubic pressure, knee to chest (McRoberts maneuver), internal rotation and delivery of posterior shoulder will almost always result in successful delivery. Labor and Delivery teams should always be prepared to recognize and treat this emergency.3