Hypertensive disorders in pregnancy (HDP) is regarded as one of the most serious medical disorders during pregnancy. HDP now is classified as chronic hypertension, pre-eclampsia/eclampsia, pre eclampsia/eclampsia superimposed on chronic hypertension, gestational hypertension. Coagulation disturbance has been postulated that the placenta may release thromboplastin which causes disseminated intravascular coagulation, and that the fibrin deposition in the kidney and placenta results in the development of hypertension and placental insufficiency. Vasospasm and endothelial cell dysfunction with subsequent platelet activation and microaggregate formation account for many of the pathological features of pre-eclampsia. Day Care Unit is a comprehensive antenatal care system with standardized protocols of high-risk hypertensive obstetric patients. Daily fetal movement count (DFMC) is noted. Ultrasonography is done 3 weekly to assess fetal growth and amniotic fluid. In severe PIH, there is usually progressive deterioration of the maternal and fetal conditions. If left undelivered, complications like placental abruption, thrombocytopenia, HELLP syndrome, eclampsia, acute renal failure, DIC can occur with associated increased perinatal and maternal mortality and morbidity. Labor can be induced by PGE2 gel or vaginal tablets and ARM and oxytocin if cervix is favorable. Cesarean section is indicated when emergency delivery is needed and in cases where induction fails. Diuretics should be avoided, unless there is pulmonary edema. Eclampsia may be antepartum, intrapartum, postpartum or rarely intercurrent, when the patient seems to recover after her convulsion and pregnancy continues. Magnesium causes relaxation of smooth muscle by competing with calcium for entry into cells at the time of cellular depolarization. Chronic hypertension in pregnancy is explained. There is increased incidence of abruptio placentae, congestive heart failure, malignant hypertension, cerebrovascular accident, and renal damage. Investigations should aim at detecting treatable causes of hypertension. Creatinine, electrolytes, urates, liver function tests, 24-hour urinary creatinine clearance, renal scan, autoantibody screen, complement studies are recommended. ECG and echocardiography are recommended in any case of pre-existing hypertension.