HELLP syndrome is a fatal complication in pregnancy it consists of 3 major conditions which are hemolysis, elevated liver enzymes, and low platelet count 10% to 20% of patients with preeclampsia will develop HELLP syndrome, and 0.5% to 0.9% of all pregnancies this paper will discuss the pathophysiology, diagnosing, complications and management of this syndrome. PubMed database was used for articles selection, and the following keys were used in the mesh (("HELLP syndrome" [Mesh]) AND ("Preeclampsia" [Mesh]). In regards to the inclusion criteria, the articles were selected based on the inclusion of one of the following topics: HELLP syndrome, Preeclampsia, Management of HELLP syndrome. Exclusion criteria were all other articles, which did not have one of these topics as their primary endpoint. The incidence, etiology, and management options were analyzed. HELLP syndrome is a very serious illness and it should be managed carefully and diagnosed correctly to save maternal and fetal lives.