Background: Pregnancy-induced hypertension (PIH) is associated with adverse perinatal outcomes. Doppler ultrasound of the uterine artery (UtA), umbilical artery (UA), and fetal middle cerebral artery (MCA) is a non-invasive tool for predicting these outcomes. Objective: To evaluate Doppler ultrasound in predicting perinatal outcomes in PIH. Methods: A longitudinal study of pregnant women with PIH (gestation >26 weeks) was conducted using color Doppler to assess UtA, UA, and MCA. Doppler indices (PI, RI, S/D ratio) were analyzed in relation to perinatal outcomes, particularly low Apgar scores. Results: Umbilical artery PI showed the highest sensitivity (73.3%) for predicting low Apgar scores. The uterine artery RI had the highest sensitivity (96.7%) but low specificity. MCA SD ratio had high specificity (80%) and sensitivity (70%). Doppler indices of UtA, UA, and MCA were useful in predicting adverse perinatal outcomes, with MCA and umbilical artery abnormalities being highly specific. Conclusion: Doppler ultrasound of UtA, UA, and MCA provides valuable prognostic information in PIH. MCA and umbilical artery abnormalities are particularly predictive of adverse outcomes, while uterine artery RI, though sensitive, lacks specificity.