Background: Preeclampsia is one of the common conditions of unknown etiology which increases the risk of maternal and perinatal morbidity and mortality. Objective: 1. To find out Perinatal Mortality Rate in cases of hypertensive disorders with pregnancy. 2. To compare Perinatal Mortality Rate in Booked and Unbooked cases in cases of hypertensive disorders with pregnancy. 3. To compare Perinatal Mortality Rate in patients receiving Early and Late treatment in cases of hypertensive disorders with pregnancy. Materials and Methods: A comparative prospective Study was performed at Dept of OBS __ampersandsignamp; Gynec, P D U Medical College, Rajkot over a period of June 2011 to May 2012. All the patients admitted with the diagnosis of hypertensive disorders with pregnancy were included in the study. A detailed history, with clinical symptoms and sign, laboratory investigations, diagnosis, and neonatal outcome were recorded in the predefined questionnaire proforma. Up to seven-day neonatal follow up was done. Results: Perinatal mortality rate in cases of hypertensive disorders with pregnancy of our study was 327/1000 live births (36 out of 110 cases). In our study, we found 54 booked cases and 56 unbooked cases; out of which perinatal mortality was in 9(16%) cases in booked__ampersandsignnbsp;case while 27 (48%) cases in unbooked cases. So, Perinatal Mortality Rate in booked cases was 166 / 1000 live birth while in unbooked cases it was 482 / 1000 live birth. Perinatal mortality rate was three times higher in unbooked cases (P = 0.0004).__ampersandsignnbsp;Perinatal mortality rate in patients early diagnosed and treated was 127/1000 live births, while in delay diagnosed and treated was 476/1000 live births. So, perinatal mortality rate was three __ampersandsignamp; half times higher in cases delay diagnosed __ampersandsignamp; treated cases (P = 0.0001). Conclusion: We studied impact of hypertensive disorders with pregnancy on Perinatal outcome and found Perinatal mortality rate of 327/1000 live births. PMR was significantly high in unbooked and cases with delayed treatment. So, we concluded that early diagnosis and treatment of hypertensive disorders with pregnancy can improve perinatal outcome.