The course of preeclamptic/eclamptic patients may be complicated by HELLP syndrome, a syndrome of intravascular hemolysis (H), elevated liver enzymes (EL) and low platelets count (LP). These patients typically present at early third trimester with epigastric or right upper quadrant pain, nausea and vomiting. They may present without the clinical signs of preeclampsia. The most frequent maternal complication are intravascular coagulopathy and acute renal failure. The grave prognosis for mother and fetus warrants physician awareness in order to accomplish early diagnosis and proper management.