Hypertensive disorders of pregnancy (HDP) remain significant and challenging issues in obstetrics, particularly in India, where the prevalence of HDP is 7.8%, with pre-eclampsia affecting 5.4% of the study population. HDP can affect multiple systems, including cardiovascular, respiratory, neurological, renal, hematologic, hepatic, and uteroplacental. The management goals are to facilitate the birth of a healthy infant and restore the mother's health, or terminate the pregnancy with minimal trauma in severe cases. Key management strategies include obstetric management, fetal surveillance, antihypertensive therapy, anticonvulsant treatment, safe analgesia for labor, and anesthesia for delivery. Antihypertensive drugs like labetalol, hydralazine, and nifedipine are used, while magnesium sulfate is crucial for controlling seizures. Fluid therapy and low-dose aspirin have also shown benefits in preventing and managing HDP. Anaesthetic management in HDP involves careful assessment, optimization of physiology, and expedited delivery, with a preference for regional anesthesia over general anesthesia to avoid complications. HELLP syndrome, a severe form of pre-eclampsia, requires prompt stabilization and early delivery.Hypertensive disorders of pregnancy (HDP) remain significant and challenging issues in obstetrics, particularly in India, where the prevalence of HDP is 7.8%, with pre-eclampsia affecting 5.4% of the study population. HDP can affect multiple systems, including cardiovascular, respiratory, neurological, renal, hematologic, hepatic, and uteroplacental. The management goals are to facilitate the birth of a healthy infant and restore the mother's health, or terminate the pregnancy with minimal trauma in severe cases. Key management strategies include obstetric management, fetal surveillance, antihypertensive therapy, anticonvulsant treatment, safe analgesia for labor, and anesthesia for delivery. Antihypertensive drugs like labetalol, hydralazine, and nifedipine are used, while magnesium sulfate is crucial for controlling seizures. Fluid therapy and low-dose aspirin have also shown benefits in preventing and managing HDP. Anaesthetic management in HDP involves careful assessment, optimization of physiology, and expedited delivery, with a preference for regional anesthesia over general anesthesia to avoid complications. HELLP syndrome, a severe form of pre-eclampsia, requires prompt stabilization and early delivery.