AbstractObjectives: Incidence of eclampsia in the western world is 1 in 2000 and 1 in 3448 pregnancies, but it is many times high in developing countries with incidence of 1.5% in India. Posterior Reversible Encephalopathy Syndrome (PRES) also known as reversible posterior leukoencephalopathy syndrome occurs in association with a number of causes, most commonly hypertension, pre-eclampsia/eclampsia and renal injury. Aim of the study was to find about the incidence of PRES in patients with antepartum eclampsia by brain imaging using MRI and MRV. Material and methods: It was a retrospective cohort study of all patients of antepartum eclampsia with PRES syndrome over a period of two years from 1st June 2017 to 31st July 2019 managed at Basaveshwar Teaching and General Hospital, attached to Mahadevappa Rampure Medical College, Kalaburagi, Karnataka, India. Results: A Total of 140 patients with antepartum eclampsia delivered at Basaveshwar Teaching and General Hospital, attached to Mahadevappa Rampure Medical College, Kalaburagi, Karnataka during the study period; that is between 1st June 2017 and 31st July 2019. Of these 14 patients had PRES with an incidence of 10% of all patients with antepartum eclampsia. The incidence was more in primigravidas (78%) than in multigravidas (22%). 10 patients were 20–25 age group, 13 presented with multiple seizure episodes. In 12 patients seizures were controlled only with MgSO4. Mode of delivery was by vaginal route in 5 patients. Perinatal mortality was seen in 5 patients. There was no maternal mortality in our study. Conclusion: Incidence of PRES was 10% amongst the patients delivered with antepartum eclampsia at Basaveshwar Teaching and General Hospital, Kalaburagi. Signs of imminent eclampsia headache, epigastric pain and blurring of vision were present in these patients. In the majority of the patients seizures were controlled with MgSO4 alone. MRI and MRV were the investigation of choice. Prognosis of PRES in patients with antepartum eclampsia was favorable.