Aim To investigate the optimal time and mode of termination of pregnancy for patients with hemolysis,elevated liver enzymes and low platelet syndrome(HELLP syndrome). Methods The data of 47 cases with HELLP syndrome were retrospectively analyzed.According to the length from the diagnosis-confirmed time to the time of delivery,the patients were divided into 2 groups: groupⅠwith 48 hours,groupⅡover 48 hours.The blood test,clinical presentations,maternal-neonatal complications and outcomes were compared between the two groups. Results The incidence of placental abruption,acute renal failure,heart failure,DIC was 38.9%,33.3%,27.8%,27.8% respectively in groupⅡ,significantly higher than those in groupⅠ(P><0.05),significant difference was found in neonatal respiratory distress syndrome(NRDS),neonatal asphyxia and perinatal mortality rate between the two groups(10.4% vs 33.3%,10.4% vs 44.4%,10.4% vs 33.3%(P><0.05). Conclusion HELLP syndrome is serious to both mother and fetus.The cases for expectant treatment should be strictly selected based on the conditions of mothers and fetus.Cesarean section is the first choice in 48 h after diagnosis.