Background The leadless Micra pacemaker has emerged as a safe and minimally invasive alternative for selected patients with arrhythmias. However, as the technology is still relatively new, clinical experience with urgent device retrieval—particularly in critical care settings—remains limited. Case Summary An 85-year-old female with chronic atrial fibrillation and complete heart block underwent Micra pacemaker implantation. Within minutes of tether removal, the device became dislodged and migrated between the tricuspid valve and the right ventricular apex, resulting in nonsustained ventricular tachycardia. Immediate retrieval was performed using a double-snare technique through a single 23-French delivery sheath. The pacemaker was successfully extracted within 40 minutes, with no complications. Discussion This case highlights a rare but critical complication of leadless pacemaker dislodgement, requiring urgent recognition and rapid procedural response. The double-snare technique enabled safe and efficient retrieval through a single access site, minimizing procedural time and trauma—key considerations in high-risk and elderly patients. As leadless pacing becomes more widespread, familiarity with emergency retrieval strategies and procedural adaptability will be essential, particularly in intensive care and interventional cardiology settings.