The HELLP syndrome (hemolysis, elevated liver enzymes, low platelets) is a pathological entity in obstetrics that is related to preeclampsia. Recognition and early treatment are mandatory, because of the high fetal and maternal morbidity and fetal mortality rates. This report features the CT and MRI findings in two patients with HELLP syndrome, upper abdominal pain, and severe liver cell dysfunction. Despite the extensive hepatic abnormalities seen on CT and MRI studies, both patients recovered fully after delivery. The role of imaging studies for diagno- It sis and treatment planning in the clinical setting of HELLP syndrome is discussed.