Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 4 2025 04 01 701 709 Yang Qiang Department of Gynecology, Taixing People's Hospital, Taizhou, Jiangsu, China Ding Xiaoli Department of Gynecology, Taixing People's Hospital, Taizhou, Jiangsu, China Nawsherwan . Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China Qian Lihua Department of Gynecology, Taixing People's Hospital, Taizhou, Jiangsu, China 2024 12 24 2025 04 01 Hypertensive disorders of pregnancy (HDP) are the predominant pregnancy complication in both high and low-middle-income countries. The age-standardized incidence rate and the absolute incidence number of HDP in low-middle-income countries are 2-fold and 4-fold higher than in high-income countries in 2021, respectively.  However, the reduction in the age-standardized prevalence rate (-41.1% vs. -8.7%) and incidence rate (-40.8% vs. -7.1%) of HDP is ≈5-fold faster in low-middle income countries compared with high-income countries between 1990 and 2021. Moreover, HDP is significantly associated with the increased risk of adverse perinatal outcomes, including preterm birth, low birth weight, and perinatal mortality in both high and low-middle-income countries. In the current review, we have highlighted the prevalence, incidence, and temporal trend of HDP and its association with adverse perinatal outcomes in high and low-middle-income countries.  https://ijph.tums.ac.ir/index.php/ijph/article/view/37600 https://ijph.tums.ac.ir/index.php/ijph/article/download/37600/8512