Abstract: Objective: To evaluate the related factors for adverse maternal and fetal outcome among women with HELLP syndrome (hemolysis,H, elevated liver enzyme, EL, low platelet count, LP).Methods: We retrospectively analyze maternal and fetal medical records of pregnancy complicated HELLP syndrome from January 1, 2005 to December 31, 2009. Related factors included maternal age, parity, gestational age at diagnosis, adverse maternal and fetal outcomes. Statistical analysis was performed with the χ2 test analysis.Results: A total of 32 pregnant women with HELLP syndrome were reviewed. The incidence of HELLP or ELLP was 2.16% among the women with severe pre-eclampsia (32/1484). Gestational age at diagnosis was about 32 weeks and 4 days, with a peak frequency between the 27th and 37th gestational weeks. In about 84.4% of the cases, the HELLP syndrome develops before delivery. The rests develops within 48 h after delivery. The incidence of maternal complication, such as eclampsia, abruption placenta, postpartum bleeding, acute renal deficiency was higher among women with HELLP syndrome as compared with ELLP. The incidence of HELLP was significantly associated with a platelet nadir below 50x109/L (p<0.05). High incidence of fetal and neonatal death was present before 30 weeks of gestational age and with intrauterine growth restriction. High incidence of HELLP syndrome was also present in women without regular care during pregnancy. Conclusions The maternal adverse outcome of HELLP was higher than ELLP. There was a significant association between a platelet nadir below 50x109/L and the severity of HELLP. The perinatal mortality and morbidity was high before 30 weeks. Regular care during pregnancy may play an important role in prevention maternal and fetal adverse outcomes.