Whether it is a particular clinical form of pre-eclampsia (PE) or a separate entity, the HELLP SYNDROME (HS) is a serious factor added to a vascular-renal terrain, often very progressive, sometimes in a super-acute manner in the form of a syndrome of multi-visceral failure, serious for the mother and fatal for the fetus. Characterised by symptomatic, evolutionary and ethological polymorphism, it can reveal a chronic condition, whether it is a nephropathy, an auto-immune or thrombophilic condition. It is a true general disease with a heavy maternal and perinatal morbidity. Like eclampsia, retro placental haematoma, intra uterine growth retardation, respiratory distress and renal failure all require a multidisciplinary approach by a specialised team. Finally, its diagnosis and management are still the subject of controversy.