Elena Gilbert becomes a vampire at the end of Season 3, Episode 22 ("The Departed") of The Vampire Diaries. She is dying due to injuries and cerebral bleeding, and Dr. Meredith Fell saves her by giving her vampire blood (from Damon Salvatore) when she is in the hospital. Elena then dies in a car crash caused by Rebekah Mikaelson but wakes up as a vampire in transition because of the vampire blood in her system. She completes her vampiric transformation in Season 4, Episode 1 ("Growing Pains"), when she feeds on human blood to fully turn into a vampire.