The World Health Organization (1998) identifies pre-eclampsia as the third most significant cause of international maternal death; it also carries a high risk of fetal/perinatal morbidity and mortality (Bewley 2004). Although much research has been undertaken to find the cause of pre-eclampsia, no definitive origin has been established (Bewley 2004). Rather than being classified as a single disease, it is thought of in terms of a variety of symptoms suggestive of a multi-faceted condition or syndrome (Stevenson & Billington 2007), which can sometimes present problems for diagnosis and treatment (Bewley 2004). To ensure maternal and fetal well-being in pregnancy, it is imperative that any indications of pre-eclampsia are recognised antenatally (NICE 2003). Intrapartum and postnatal care should also be managed to a high standard by a multidisciplinary team as this high-risk condition of pregnancy needs specialised care (Stevenson & Billington 2007). This article explores all aspects of pre-eclampsia and its necessary treatment, whilst considering the key role midwives play in assessing risk and performing clinical assessments. It also provides insight into how midwives can care for the pre-eclamptic woman and her baby by providing good quality, informed, clinical and emotional care in conjunction with a multidisciplinary approach.