Background: To assess early neonatal outcome in low- birth weight babies in hypertensive disorders complicating pregnancies with the mode of delivery. Materials and Methods: Eighty- women delivering low birth weight babies with hypertension complicating pregnancies were divided into 2 groups of 40 each. Group I was vaginal delivery group and group II was caesarean delivery group. Parameters such as types of hypertensive disorders in pregnancies, early neonatal outcome and neonatal complications were recorded. Results: There were 18 patients in group I and 20 in group II with preeclampsia, 6 in group I and 7 in group II eclampsia, 12 in group I and 11 in group II gestational hypertension and 4 in group I and 2 in group II chronic hypertension with superimposed preeclampsia. The difference was non- significant (P> 0.05). Age group 21-25 years had 26 patient sin group I and 25 in group II. There were 28 Primigravida in group I and 24 in group II and 12 multigravida in group I and 16 in group II. SES was lower in 27 in group I and 22 in group II, middle in 10 in group I and 13 in group II and upper in 3 in group I and 5 in group II. The difference was significant (P<0.05) (Table II). APGAR at 1 minute (4-6) was seen in 28 and 26, APGAR at 5 minutes (7-10) was seen in 21 and 25, NICU admission was present in 27 and 31 and NICU admission was absent in 13 and 9 in group I and II respectively. The difference was significant (P<0.05). Neonatal complications observed were RDS in 15% and 21%, birth asphyxia in 12% and 6%, intraventricular haemorrhage (IVH) in 7% and 3%, meconium aspiration syndrome (MAS) in 6% and 3% and sepsis in 7% and 5% in group I and II respectively. The difference was significant (P<0.05). Conclusion: Neonatal outcomes are not worsened by spontaneous or induced vaginal delivery in women with hypertension with good control and also decreases morbidity due to caesarean section to the mother. Caesarean delivery offers no short-term survival advantage compared with vaginal delivery for LBW vertex presenting foetuses in PIH patients.