Hypocalcemia is an uncommon electrolyte abnormality. We evaluated a young woman with episodes of recurrent symptomatic hypocalcemia, which had started in her late teens. She was hypertensive and laboratory evaluation revealed elevated parathyroid hormone, elevated phosphate, and decreased renal phosphate excretion along with low ionized calcium levels. Her renin and aldosterone levels were elevated. While the response to treatment with calcium and 1,25(OH)2 dihydroxyvitamin D was modest, her laboratory values and symptoms improved significantly during pregnancy and then recurred post-delivery.