IntroductionrnMaternal death as a result of preeclampsia/eclampsia is progressively increasing in Ethiopia;rnspecifically Addis Ababa; contributing to the challage faced in meeting millennium developmentrngoal (MDG) 5.Preterm birth is amajor contributor for poor perinatal outcome in pregnanciesrncomplicated by severe preeclampsia and every effort should be made to prolong the pregnancyrntill a favorable gestational age is reached. In doing so, one needs to give due emphasis torndecrease maternal mortality and morbidity. This makes management of pregnancies complicatedrnby severe preeclampsia challanging.rnObjectivernThe main objective of this study is to describe management option selected for pregnanciesrncomplicated by severe preeclampsia in the three teaching hospitals& relate it to maternal &rnperinatal outcomes at different gestational ages.rnMethods:rnA prospectivedescriptive cross sectional studywas conductedon women whose pregnanciesrncomplicated by severe preeclampsia and got managed at the three teaching hospitalsin AddisrnAbaba, Ethiopia; namely: TikurAnbesa Specialized Hospital (TASH), Ghandi MemorialrnHospital (GMH), and Zewditu Memorial Hospital (ZMH) from May to July, 2014. Data wasrncollected with a pre tested structured questionaire. Datawas entered; cleaned, coded& analyzedrnusing Statistical package for social sciences (SPSS)version 20 and important conclusions andrnrecommendations were generated.rnResults: There were a total of 3351 deliveries attended at the three teaching hospitals withrnprevalence of severe preeclampsia accounting for 279 (7.8%). Cases of merely severernpreeclampsia were 135 (48.4%); 116 (41.6%)HELLP syndrome& 28 (10%) eclampsia. Fromrnthose patients who presented at < 34 weeks; fifty two (50.5%) had their pregnancies terminatedrnimmediately while the remaining patients gained 10.1 days on average. There were 13 (26%) stillrnbirths in those who presented at < 34 weeks and put under conservative management. Nineteenrn(37.3%) still births recorded in the same category of patients whose pregnancies were terminatedrnimmediately after admission. Risk of still birth was found to be significantly increased in thosernpregnancies that were conservatively managed.rnConclusion: Prevalence of severe preeclampsia is progressively increasing with worsening ofrnpoor perinatal outcome especially for those presenting with sever preeclampsia remote from termrnthat were managed conservatively. Therefore it is wise to revisit the selection criteria used forrnconservative management in order to improve feto-maternal outcom