Background: Hypertensive disorders of pregnancy (HDsP) affect 5 to 22% of pregnancies worldwide. Despite extensive global research, etiology, management, prevention remains elusive. When prevention is not possible, early diagnosis can save mothers and babies despite disorders, but rural women especially in developing countries lack awareness, health services, resources too, so suffer much more. Objectives: Community-based study was carried out to know about burden, effects of HDsP amongst rural women of remote hilly regions. Material Methods: After the base institute’s ethics committee’s approval, prospective study was carried out in 100 villages. Information about HDsP was collected from women’s antenatal records by a research assistant. However, blood pressure was measured by the research assistant also. If BP was high, diagnosis of HDsP was at referral, study centre. Detailed workup of many could not be done, so this wasn’t part of study. Results: Of 3713 women who delivered during study period of over 2 years, 455 (12.3%) had HDsP. Overall 280 (7.6%) had moderate gestational hypertension (GH)/preeclampsia (PE), 129 (3.5%) severe, 46 (1.2%) eclampsia and 3258 (87.7%) were normotensive. Of 1133 women aged 15-19 years, 159 (14%) had HDsP, of 207 of 30-34 yrs 8.2%. Of 1241 almost illiterate (some had gone to school for one or 2 years) 179 (14.4%) had HDsP, 109 (8.8%) moderate, 49 (3.9%) severe disease and 21(1.7%) had eclampsia. Of 113 (3.0%) women who were postgraduate educated, 4 (3.5%) had HDsP. Of 853 Unskilled workers, 96 (11.3%) had HDsP, of 2301 Homemakers, 321 (14.0%) had HDsP, of 1384 Primigravida, 189 (13.7%) had HDsP, of 868 with 3 or more births, 75 (8.6%) had HDsP, significant difference between primi and multigravida. One-third of maternal deaths during the study period were due to Eclampsia and 62(42.17) perinatal deaths out of total 147 perinatal deaths were in women with HDsP. Conclusion: HDsP were common in rural, tribal women of remote villages. They lead to a lot of maternal, perinatal loss. However many gaps were identified which need a lot of research