Objective: HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets) is a component of hypertensive disorders of pregnancy that is associated with significant maternal and perinatal morbidity and mortality. HELLP syndrome is regarded as a high risk for the mother and neonate compared to preeclampsia. Aims: This study evaluates the maternal and perinatal outcome in HELLP syndrome so that the management is improved resulting in reduced mortality and morbidity. Materials and methods: It is an observational study where a total number of 56 cases of HELLP syndrome above 24 weeks of gestational age were admitted in Vanivilas Hospital, Bengaluru, during the study period of 24 months from October 2010 to October 2012. Results: In the present study, majority (71.43%) of the patients were unbooked. There was no difference in parity among cases. Maternal mortality was 7.14% and perinatal mortality was 46.43%. Conclusion: We have to intensify our efforts to reduce preeclampsia with HELLP syndrome from the grassroot level with regular antenatal care, early detection of preeclampsia, and its prompt management and early detection of complications with timely intervention.