Hypertensive disorders in pregnancy are major cause of maternal death and fetal prematurity. Death associated with hypertensive disorders may be duo to cerebrovascular event, renal or hepatic failure, HELLP syndrome, or other complications of hypertension.Hypertension during pregnancy is classified according to degree of high blood pressure, associated signs and symptoms, and time of onset during pregnancy to:1- Chronic hypertension: high blood pressure detected before the first 20 weeks of gestation.2- Gestational hypertension: high blood pressure that begins after 20 weeks of gestation and is not accompanied by protein in the urine.3- Preeclampsia: high blood pressure that begins after 20 weeks of gestation and is accompanied by proteinuria.4- Preeclampsia superimposed on chronic hypertension: It is characterized by new onset of proteinuria (or by sudden increase in the protein level, if proteinuria already is present), an acute increase in the level of hypertension or development of HELLP syndrome.5- Eclampsia: a life threatening condition defined by the presence of convulsions and typically preceded by preeclampsia.The aetiology of preeclampsia is still unknown but there are several risk factors that explain the occurrence of pregnancy induced hypertension, some of this risk factors include age and parity, family history, genetic factors, obstetric factors, race, obesity, smoking and preexisting medical condition.Numerous theories are suggested to explain the etiology of preeclampsia but they still under-consideration, from these theories: defect in placentation and placental perfusion, endothelial cell activation, procoagulant proteins and plasminogen activators and prostaglandin theory.Pathological changes occur in preeclampsia eclampsia are very dangerous and include: haemodynamic changes, haemoconcentration, coagulation changes and thrombocytopenia also there are pathological changes in multiorgans e.g. liver, brain and kidney in the form of hepatic rupture, subcapsular hematoma and liver failure, pathological changes in the brain in the form of hypertensive encephalopathy, coma and blindness.HELLPS syndrome usually develops suddenly during pregnancy (27-37 week gestation) or in the immediate pureperium. The diagnosis of HELLP syndrome is most assured in a pregnant patient with signs and symptoms of preeclampsia-eclampsia and a triad of laboratory abnormalities suggesting red cell trauma (H = Hemolysis), hepatic damage and dysfunction (EL = Elevated Liver enzymes) and thrombocytopenia (LP = Low Platelets).HLEEP syndrome classified into true or ”complete” HELLP which is characterized by:1) Moderate to sever thrombocytopenia.2) Hepatic dysfunction.3) Evidence of hemolysis.And partial or ”incomplete HELLP” which missing one or more of the criteria of complete HELLP e.g.: ELLP syndrome (missing hemolysis), EL Syndrome (severe preeclampsia with mildly Elevated Liver enzymes, absent thrombocytopenia).Maternal and perinatal outcomes are progressively worse fore patients with preeclampsia, partial HELLP syndrome and complete HELLP syndrome.A variety of strategies used to prevent or modify the severity of PE have been evaluated e.g. diuretics and other antihypertensive drugs, magnesium, zinc and calcium supplementation, antithrombotic agents, dietary manipulation and antioxidant. In general no of these have been found to be clinically efficacious.Gestational hypertension and mild preeclampsia require good antenatal care so the mother and fetus should be carefully monitored. Daily fetal movement counts usually are combined with regular non-stress tests or biophysical profiles. Ultrasonic determination of fetal weight and volume of amniotic fluid at diagnosis and every three to four weeks after diagnosis may be used to monitor patients.Management of severe preeclampsia usually is termination of pregnancy without delay. Certain studies suggested expectant management of severe preeclampsia in a selected group of women with the aim of improving infant outcome without compromising the safety of the mother.The first priority in the management of eclampsia is to prevent maternal injury and to support respiratory and cardiovascular function.The next step in the management of eclampsia is to prevent recurrent convulsions. Magnesium sulfate is the drug of choice to treat and prevent subsequent convulsions in women with eclampsia.The next step in the management of eclampsia is to reduce the blood pressure to a safe range but at the same time avoid significant hypotension. The objective of treating severe hypertension is to avoid loss of cerebral autoregulation, and to prevent congestive heart failure without compromising cerebral prefusion or jeopardizing utero placental blood flow that is already reduced in many women with eclampsia.