Background: A pregnant woman has the potential for risks during pregnancy, labor, and birth. Doppler ultrasoundindicates that the frequency alteration of a sound wave, as it is reflected by a moving object, offers a safe, non-invasive, and efficient technique for evaluating uteroplacental and fetal circulation. Hence; the present study was conducted for assessing the Role of Middle Cerebral Artery Pulsatility index (MCAPI) on Doppler in Pregnancy-Induced Hypertension (PIH). Materials & methods: A cohort of 100 pregnant individuals diagnosed with pregnancy-induced hypertension (PIH) was recruited for the study. Following the ultrasound biometry assessment, the participants underwent serial Doppler studies of the uterine artery (UtA), middle cerebral artery (MCA), and umbilical artery (UmA) between 30 and 40 weeks of gestation. For the MCA Doppler waveforms, the fetal head was imaged transversely at the level of the sphenoid bones, with the circle of Willis visualized using color flow imaging. The Doppler ultrasound measurements were analyzed to predict adverse perinatal outcomes. Abnormal findings were defined as UmA-Pulsatility Index (PI) ratios exceeding the 95th percentile and MCA-PI values falling below the 5th percentile of previously established gestational age norms.Data were analyzed using SPSS version 16. The chi-square test was applied to categorical variables. Student's t-test was applied to continuous data. Results: Mean age of the patients was 29.5 years. Mean gestational age was 38.6 weeks. Out of 100 subjects, 67 percent were of severe PIH while the remaining 33 percent were of PIH. Pregnancy outcome was adverse in 59 percent of the patients. Sensitivity, specificity and diagnostic accuracy of MCA RI in identifying perinatal outcome was 71.3 percent, 75.9percent and 74.9percent respectively. Sensitivity, specificity and diagnostic accuracy of MCA PI in identifying perinatal outcome was 71.3 percent, 85.8percent and 80.6 percent respectively. Conclusion: Doppler technology plays a significant role in the continuous noninvasive hemodynamic assessment during pregnancy. In obstetric patients who exhibit a high incidence of complications such as pregnancy-induced hypertension (PIH), Doppler indices derived from fetal circulation have been shown to effectively forecast negative perinatal outcomes.