Fatal complications following the performance of the Heimlich maneuver have been reported. A 76-year-old woman presented to the emergency department with signs of respiratory distress, abdominal pain and distension one day after airway obstruction and subsequent resuscitation. Despite successful immediate laparotomy and repair of a ruptured stomach, she later succumbed to the sequelae of aspiration of gastric contents and dehiscence of the gastric tear. This is the 4th case of stomach rupture and the 7th reported fatal complication following the Heimlich maneuver. It is recommended that persons who undergo the Heimlich maneuver be examined and observed by a physician, as soon as possible, to rule out complications.