Background: Hypertensive disorders of pregnancy (HDP) remain a significant cause of maternal and fetal morbidity and mortality. The early identification of hematological and biochemical alterations in HDP can aid in risk stratification and management. Objectives: This study aims to analyze hematological and biochemical profiles in pregnant women with HDP, categorizing them into severe and non-severe cases and correlating these parameters with fetal outcomes. Methods: A case-control analytical study was conducted over 1.5 years, including 70 pregnant women diagnosed with HDP and 70 normotensive pregnant controls. Hematological parameters such as hemoglobin (Hb), hematocrit (Hct), total leukocyte count (TLC), platelet count, and biochemical markers, including liver and kidney function tests and lactate dehydrogenase (LDH), were analyzed. Statistical significance was determined using appropriate tests, with p < 0.05 considered significant. Results: Significant alterations were observed in hematological and biochemical markers among HDP cases compared to controls. Lower platelet counts and higher LDH levels were associated with severe HDP. Liver and renal function markers showed significant deviations, correlating with disease severity. Adverse fetal outcomes, including intrauterine fetal demise and fetal distress, were more prevalent in severe HDP cases. Conclusion: Haematological and biochemical parameters provide valuable insights into the severity of HDP and its impact on fetal outcomes. These markers may serve as useful adjuncts in clinical decision-making and early intervention strategies to reduce maternal and perinatal complications.