Introduction: Hypertensive disorders of pregnancy are a major cause of maternal and perinatal complications, ranking second only to embolism as a leading cause of maternal mortality. These conditions affect approximately 12% to 22% of pregnancies worldwide. This study aimed to provide localized evidence on the prevalence of HELLP syndrome in pregnancy-induced hypertension (PIH), including preeclampsia and eclampsia, to enhance awareness and improve clinical management among obstetricians. Objective: To determine the frequency of HELLP syndrome among women with pregnancy-induced hypertension. Methodology: The study design was cross-sectional study conducted at the Department of Obstetrics and Gynaecology, MTI-Lady Reading Hospital, Peshawar from July 31, 2021, to January 31, 2022. A comprehensive clinical evaluation and routine antenatal laboratory investigations were performed on all participants. Management of patients adhered to the Royal College of Obstetricians and Gynaecologists (RCOG) guidelines for preeclampsia and eclampsia. Data collection and follow-up extended through delivery and the postpartum period to identify cases of HELLP syndrome. Results: The frequency of HELLP syndrome was recorded in 90 out of 369 women (24.4%) with pregnancy-induced hypertension. Conclusion: HELLP syndrome represents a severe manifestation of hypertensive disorders in pregnancy. This study highlights the importance of early identification and appropriate treatment to manage these cases effectively and reduce associated maternal and fetal risks.