Introduction: Severe pre-eclampsia and eclampsia are life-threatening complications of pregnancy that significantly impact maternal and fetal health. This study aimed to evaluate the feto-maternal outcomes of pregnant women diagnosed with these conditions. Material and Methods: A retrospective study was conducted at a tertiary care hospital, including 90 pregnant women diagnosed with severe pre-eclampsia or eclampsia. Inclusion criteria were singleton pregnancies ≥20 weeks gestation with a confirmed diagnosis of severe pre-eclampsia or eclampsia. Exclusion criteria included multiple pregnancies, chronic hypertension, and other major medical comorbidities. Data on maternal and neonatal outcomes were collected and analyzed. Results: The study revealed high rates of adverse maternal outcomes, including placental abruption (13.3%), HELLP syndrome (8.9%), and maternal mortality (2.2%). Neonatal outcomes included preterm birth (46.7%), low birth weight (41.1%), and neonatal intensive care unit (NICU) admission (33.3%). Conclusion: Severe pre-eclampsia and eclampsia are associated with significant maternal and neonatal morbidity and mortality. Early diagnosis, timely intervention, and multidisciplinary care are essential to improve outcomes.