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To save email as PDF in Outlook 2019 with attachments, you can follow these steps. First, open the email you want to save in Outlook. Then, go to the "File" menu and select "Save As." Choose a location on your computer where you want to save the email. Next, select "PDF" from the "Save as type" dropdown menu. Optionally, you can adjust the file name and select additional options such as including attachments or saving the entire email or just the selected portion. Once you've made your selections, click "Save" to save the email as a PDF file with attachments. This process ensures that both the email content and any attached files are preserved in the PDF format for easy access and sharing.