Background: Pregnancy-associated pulmonary hypertension (PAPH) is a severe pregnancy complication resulting from elevated blood flow and angioproliferative alterations. Untreated, the condition increases maternal and fetal mortalities; and in extreme case leads to maternal death. Medical treatment is paramount to prevent adverse drug effects; risk-benefit analysis; and promote Maternal and Neonatal well being.Objectives: To assess the nature of pharmacological management of PAPH in pregnant women and their outcomes following targeted pulmonary therapy.Study design: A Cross-Sectional study.Place and duration of study. Department of Gynecology and Obstetrics Gajju khan medical college Swabi form Jan 2022 to Jan 2023Methods: A cross-sectional descriptive prospective study was conducted on one hundred and fifty pregnant women diagnosed as pulmonary hypertension. Patient received pulmonary vasodilators, anticoagulants and supportive care. Histories of the patients were adequately followed to the last months of pregnancy and even after delivery. Maternal variables including mother survival, fetal status and maternal hemodynamics were other measurements made. Descriptive analysis involved using standard deviation and p-value to compare the treatment effects for purpose of credibility of the results.Results: Among 150 patients, who had a combination of endothelin receptor antagonists and phosphodiesterase-5 inhibitors, mean pulmonary artery pressure was increased (± SD = 35.4 ± 5.6 mmHg). For maternal survival it was 90%, the p-value was < 0.05 for all the results for the maternal aspect as well as the fetal aspect. That led to a decrease in fetal complications to the level of 8%. Overall, adherence to the given treatment yielded actual positive changes in QoL and decreased the number of readmissions.Conclusions: Hence pharmacological management of PAPH is imperative in minimizing maternal and fetal risk factors. Specific treatments produced a positive impact on durability and results. The combination of referrals to multiple practitioners and the development of a personal treatment course increase safety and effectiveness during pregnancy.