A 25-year-old woman, gravida 4 para 2 at 18 weeks’ gestation, presented with hematemesis and severe anemia (hemoglobin 4 g/dL). Ultrasound revealed a live fetus and portal cavernoma, and endoscopy showed large gastric varices with grade II–III esophageal varices. EUS-guided embolization was planned after gynecologic clearance. Using a linear echoendoscope, a 34×20 mm cluster of fundal varices with a feeder vessel was identified. The feeder was punctured with a 19-G needle, a coil (0.035-14-18 Nester) was deployed, and 1 mL of N-butyl cyanoacrylate was injected, followed by a distilled water flush. EUS confirmed complete obliteration, and esophageal varices were ligated. EUS allows coil deployment, minimizing glue volume and embolization risk. This appears to be the first reported case of EUS-guided embolization in pregnancy.