ABSTRACT Objectives: To determine the risk factors associated with the development of Hellp Syndrome (HS) in pregnant women attended at the Instituto Nacional Materno Perinatal, 2018-2021. Materials and methods: The study is a retrospective cross-sectional analysis using a case-control design. Twenty-five hundred medical records were collected and 196 cases and controls with Hellp syndrome (HS) were selected following eligibility criteria. A data collection form including variables and study dimensions was used. For the analysis, SPSS software was used, applying frequency techniques and Pearson's Chi-square tests to evaluate associations. Results: In cases of Hellp syndrome (HS), higher frequencies were observed in single and cohabiting women, representing 16.8% (p = 0.583); with primary education level in 20.4% (p = 0.195). Regarding age, 12.2% of SH cases were women between 30 and 32 years of age (p = 0.640). A higher proportion of cases were found with a history of arterial hypertension, with 29.1% (OR: 1.230), and in those with malnutrition, with 27.6% (OR: 1.780). There was no significant association with parity, but a higher frequency of cases was observed in nulliparous women, with 17.9% (OR: 1.538), and in pregnant women with a gestational age of 40 weeks, with 6.1%. Conclusions: Malnutrition is the statistically significant risk factor associated with the development of SH.