Abstract: Objective: The aim of this study was to evaluate the efficacy and safety of intravenous hydralazine in comparison with labetalol in pregnancy related hypertension. Place and Duration of Study: This study was carried out in a duration of 9 months from February 2019 to October 2019 in medical departments of Indus hospital Karachi. Study type: Comparative study. Materials and methods: A total of 152 patients were selected for this study and two groups were formed. One was hydralazine group and other was labetalol group. Initial reading of blood pressure was done followed by a dose of hydralazine in one group and labetalol in other group. After that side effects, dose and time required to achieve the desired blood pressure was noted. Results: 69.5% of the patients in hydralazine group achieved the required blood pressure with the 1st dose. Significantly higher number of 81.5% was seen in case of labetalol group who achieved desired blood pressure with 1st dose. Results of our study showed that rapid control of blood pressure is achieved with labetalol as compared to hydralazine. Side effects were also noted in both groups. Conclusion: It was concluded from our study that both drugs were efficient in decreasing the blood pressure in pregnancy related hypertension to desired levels. However, labetalol is superior and more efficient in decreasing blood pressure as compared to hydralazine.