Sindrom HELLP dan Acute Fatty Liver of Pregnancy (AFLP) merupakan komplikasi berat kehamilan. Kedua kondisi ini dapat mengancam jiwa dan diagnosis awal amat penting untuk mencegah kematian. Gejala sindrom HELLP dan AFLP sekilas nampak sama, namun etio-patogenesis serta penanganan keduanya berbeda. Pembahasan kasus ini bermaksud mengingatkan klinisi agar mempertajam diagnosis dan penanganan untuk hasil yang lebih baik. Penanganan yang cepat dan tepat menjadi tantangan bagi dokter umum dan spesialis kebidanan di negara-negara berkembang, di mana kehamilan dengan komplikasi sering kurang tertangani.HELLP syndrome and Acute Fatty Liver of Pregnancy (AFLP) are very serious complications in pregnancy. These conditions are life threatening and early diagnosis is the most important step to prevent mortality. HELLP syndrome and AFLP have similarities in symptoms and clinical appearance but different in etio-pathogenesis and treatment. Even though AFLP is rare, it is associated with high maternal and neonatal mortality. This case serves as a reminder to early diagnosis and treatment for a better outcome. This will be a challenge for general practitioners and obstetrician in developing countries, where pregnancies with complications often remain undersupervised.