Background: The hypertensive disorders of pregnancy are among the leading causes of maternal and fetal morbidity and mortality. This study was conducted to assess early neonatal outcome in low- birth weight babies in mothers with hypertensive disorders. Materials &Methods: 70 women with hypertension delivering low birth weight babies were divided into 2 groups of 35 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: Pre-eclampsia was seen in 12 in group I and 14 in group II, eclampsia 8 in group I and 7 in group II, gestational hypertension 10 in group I and 8 in group II and chronic hypertension with superimposed preeclampsia 5 in group I and 6 in group II. The difference was non- significant (P> 0.05).APGAR at 1 minute (4-6) was seen in 20 and 22, APGAR at 5 minutes (7-10) was seen in 15 and 13, neonates & groups I&II NICU admission was present in 26 and 24 and NICU admission was absent in 9 and 11 in neonates in group I and II respectively. Neonatal complications observed were RDS in 3 and 5, birth asphyxia in 6 and 3, intraventricular haemorrhage (IVH) in 3 and in group I and II respectively. The difference was significant (P<0.05). Conclusion: Caesarean delivery offers no short-term survival advantage compared with vaginal delivery for low- birth weight vertex in PIH patients.