Open AccessHELLP Syndrome is a life threatening complication of severe pre eclampsia ,which is characterized by evidence of hemolysis, elevated liver enzymes and low platelet count during second half of pregnancy.If untreated , it carries high risk of maternal and perinatal morbidity and mortality due to hepatic and renal complications. A case of HELLP Syndrome with severe pre eclampsia in a primigravida at 39 weeks of pregnancy is reported. She was a known case of severe pre eclampsia and was taking treatment in a private nursing home.She was refered with a picture of HELLP Syndrome.Caesarean section under general anesthesia for fetal distress was carried out following single donar platelet transfusion. She had gross derrangement of hepatic and renal functions and thrombocytopenia following caesarean section. She was treated aggresively in intensive care unit with transfusion of whole blood ,fresh frozen plasma, multiple single donar platelet transfusions ,antihypertensive agents and broad spectrum antibiotics.Patient required multidisciplinary team approach for management.Patient was discharged after fifteen days from hospital.