Aim: Thrombotic complications like thrombotic thrombocytopenic purpura (TTP), hemolytic uremic syndrome (HUS), and posterior reversible encephalopathy syndrome (PRES) in pregnancy are due to the deposits of platelet and fibrin in the microvasculature damaging and destroying the passing red blood cells (RBCs) and platelets so as to cause hemolysis, thrombocytopenia, and anemia. They are relatively rare fulminant life-threatening conditions, which can lead to significant perinatal and maternal morbidity and/or mortality. Pregnancy itself is thrombus prone and conditions like preeclamptic toxemia (PET), eclampsia, and hemolysis, elevated liver enzymes, and low platelet count (HELLP) are not only occasionally associated, but can add to the gravity of the seriousness. Case report: Three cases each of TTP, HUS, and PRES are being presented with their case history treatment and outcome to show the similarity in their presentation along with diagnostic dilemma, clinching diagnostic tests, and overall management with specific treatment in individual cases. Conclusion: The TTP, HUS, and PRES are life-threatening complications in pregnancy without any signs of early recognition. Awareness of the condition and prompt action is the need to avoid perinatal and maternal mortality and morbidity associated with these syndromes.