The present study was carried out to assess the association between ambient air pollution exposure and resistant hypertension disorders development in pregnancy by a case-control study in Tashkent city. The present study included 150 pregnant women with resistant hypertension disorders (cases) and 300 pregnant women without the disorder (controls). The chronic exposure to particulate matter pollutants less than 2.5 microns (PM₂.₅), nitrogen dioxide (NO₂), and ozone (O₃) throughout pregnancy was calculated based on the air quality monitoring station data. The comparison was made using conditional logistic regression and adjusting for the confounding effect of the variables. The findings showed the average exposure to PM₂.₅ and NO₂ in the case group were greater than that in the control group. For a 10 micrograms per cubic meter increase in PM₂.₅ concentration, the adjusted odds ratio for refractory hypertension was 2.01 (95% confidence interval: 1.51-2.68). For an 8.5 ppm increase in NO₂ concentration, the adjusted odds ratio was 1.85 (95% confidence interval: 1.41-2.42). For ozone, there was no significant association. The results from this study demonstrate that maternal exposure to elevated levels of PM₂.₅ and NO₂ air pollutants is associated with an increased incidence of refractory hypertension in pregnancy. These findings underscore the importance of taking air pollution seriously as a modifiable risk factor for this life-threatening pregnancy complication and implementing appropriate policies to improve air quality to promote maternal health.