BACKGROUND: Opinions are controversial regarding the use of general and spinal anesthesia in pre-eclamptic mothers undergoing Caesarean section. Some studies recommended avoiding spinal anesthesia in pre-eclamptic patients because of concern for sudden severe hypotension, while other studies support the use of spinal anesthesia as first choice reasoning less post-operative morbidity and mortality. This study aims to compare maternal outcome among pre-eclamptic women undergone caesarian delivery under general and spinal anesthesia.METHODS AND PATIENTS:  A retrospective comparative cross-sectional study was conducted to compare maternal outcome. All pre-eclamptic mothers who underwent Caesarian section in Black Lion Specialized Hospital from October 2014 to October 2016 were included in the study. Data entry and analysis were conducted using SPSS version 20. Student’s T-test was used to compare the outcome in both groups and p value < 0.05 was set as cut off point for statistical significance.RESULTS: A total of 170 client documents were reviewed. The mean age of the study subjects was 28.18 +4.66 years, with median age 28 years (IQR: 25-30). Our study shows that both general and spinal anesthesia have no difference in terms of maternal survival status, days of hospital stay, post-operative admission to ICU, and post-operative complications. However, this study found a statistically significant higher post-operative blood pressure and pulse rate among general anesthesia groups compared with spinal anesthesia group.CONCLUSION፡Spinal anesthesia is safer than general anesthesia in terms of stable vital signs among pre-eclamptic women undergoing Cesarean section. KEYWORDS: Spinal, General, Anesthesia, Pre-eclampsia, Maternal outcome