Background- The present study was conducted at tertiary care center to estimate gestosis score in high risk pregnant women and to study its association with fetomaternal outcome. Methodology- Retrospective study was conducted on 100 high risk women presented in labour room after 28 weeks of gestation for delivery at Department of Obstetrics and Gynecology during the study period of 6 months. Gestosis risk scorewas evaluated and itsfetomaternal outcome was assessed. Results- Mean age of women was 28.3±4.6 years while mean gestational age was 37.6±2.7 weeks. Gestosis score was more than 3 in 32% cases indicating severe risk of pre-eclampsia in these women. Gestosis score of more than 3 was significantly associated with high rate of LSCS and pre-eclampsia (p<0.05). The rate of prematurity, NICU admission and low birth weight was significantly higher in cases with gestosis score above 3 (p<0.05). Conclusions -Gestosis score is a useful tool for early identification of women at high risk for developing hypertensive disorders especially in resource limited community settings. The tool can be utilized by even primary health care provider for screening of HDP during the antenatal period.