Cerebral events occur more often in the postpartum period and are associated with hypertensive diseases of pregnancy. Superimposed with pre-eclampsia, these cause severe complications. Posterior reversible encephalopathy syndrome occurs because of acute elevation of blood pressure above the upper limit of cerebral blood flow auto-regulation. We present a case of posterior reversible encephalopathy syndrome that developed with superimposed pre-eclampsia resulting in intraparenchymal haemorrhage and maternal death.