Context: Study of maternal near miss cases reflects the standard of maternal health care and enables planning of measures to reduce maternal mortality. There is need to analyze the contribution of hypertensive disorders of pregnancy in near miss cases as they contribute to majority of maternal mortality in developed as well as developing countries. Objective: To identify and analyse incidence of near miss cases related to hypertensive disorders of pregnancy (HDP). Materials and methods: Among near miss cases (WHO criteria 2009) that occurred in a teaching tertiary care maternity hospital in Dakshinn Kannada, Southern India, during the period of June 2014 to June 2017, those cases related to HDP formed the study population. It was a retrospective observational study. Required demographic data and case details were obtained from medical records. Results: HDP were responsible for 39.4% of near miss cases (54 of 137) and 13.8% of maternal mortality (4 of 29). General maternal mortality ratio and near miss mortality ratio was 165.5/100,000 live births (210/100,00 live births – WHO 2015) and 7.81/1000 live births respectively (17520 live births). Near miss to mortality ratio was 4.7:1 and in cases with HDP ratio was 13.4:1. Among the maternal outcomes studied majority of the cases had eclampsia and HELLP as a major complication. Among fetal outcomes majority of the babies had low birth weight and required NICU admission. Conclusions: Hypertensive disorders of pregnancy are one of the leading causes of maternal near miss events (39.4%). Eclampsia and HELLP are the leading cause of near miss cases.