Background: Pregnancy-induced hypertension (PIH) is a major obstetric complication with significant maternal and fetal morbidity, particularly when associated with acute liver dysfunction and disseminated intravascular coagulation (DIC). These conditions present unique challenges, requiring timely recognition and management. This study aimed to evaluate the clinical and biochemical profiles of women with PIH complicated by liver dysfunction and DIC and assess their maternal and perinatal outcomes. Methods: A cross-sectional study was conducted at Women Medical and Dental College Abbottabad from January 2023 to January 2024. A total of 102 participants diagnosed with PIH, liver dysfunction, and DIC were included through non probability consecutive sampling. Clinical data, laboratory investigations, and maternal-fetal outcomes were analyzed. Statistical significance was determined with a p-value <0.05. Results: The mean age of participants was 28.6 ± 5.1 years, and the average gestational age was 32.4 ± 3.2 weeks. Elevated systolic (158.7 ± 12.4 mmHg) and diastolic (102.3 ± 9.6 mmHg) blood pressures were significantly associated with adverse outcomes (p < 0.01). Proteinuria (368.2 ± 75.3 mg/dL) and liver dysfunction, including elevated ALT (85.2 ± 32.7 U/L) and AST (94.8 ± 40.6 U/L), were notable findings. Coagulation abnormalities, such as prolonged PT (15.8 ± 2.3 seconds) and aPTT (38.7 ± 6.2 seconds), low fibrinogen (182.4 ± 58.3 mg/dL), and elevated D dimer levels (2375 ± 624 ng/mL), were strongly indicative of DIC (p < 0.01). Maternal outcomes included ICU admissions (41.2%), blood transfusions (34.3%), and a mortality rate of 7.8%. Fetal complications included stillbirth (11.8%), low Apgar scores (<7 at 5 minutes in 27.4%), and fetal growth restriction (35.3%). Conclusion: PIH complicated by liver dysfunction and DIC significantly impacts maternal and fetal health, leading to severe complications. Early recognition, multidisciplinary management, and timely interventions are essential to improve outcomes. Further research is recommended to develop predictive markers and optimize care for high-risk pregnancies.