OBJECTIVE To compare nifedipine (group 1) with methyldopa (group 2) in the management of pregnancy induced hypertension (PIH). METHODS A prospective clinical trial. METHODS Obstetric Unit, General Hospital, Peradeniya. METHODS A total of 126 patients with PIH were allocated alternately to either group. The patients in group 1 received nifedipine 30 to 90 mg/day and in group 2 methyldopa 750 to 2000 mg/day. METHODS Blood pressure, the extra days added to the pregnancy, number of patients treated for acute hypertensive episodes, maturity of fetus at birth, mode of delivery, birth weight, intrauterine deaths, Apgar score, maternal side effects and complications. RESULTS The two groups on admission to the study had similar periods of gestation (group 1, 33.6 + 5.9, group 2, 34.1 + 4.2), systolic blood pressure in mmHg (151 + 22, and 154 + 24) and diastolic blood pressure (108 + 12, and 108 + 12). The results showed no differences between the two groups, with respect to maturity of fetus at delivery (35.1 + 5.5, and 35.7 + 2.9), mode of delivery, number of intrauterine deaths, average systolic blood pressure in mmHg (148 + 14 and 152 + 16), average diastolic blood pressure (102 + 8 and 104 + 9), highest systolic blood pressure (169 + 24 and 167 + 30), highest diastolic blood pressure (115 + 12 and 116 + 11), birth weight in kg (2.015 + 0.957, and 1.922 + 0.660) and number of days added to the pregnancy (7 + 7, 9 + 11). The Apgar score for group 2 was better than in group 1, and less patients in group 2 required treatment for acute hypertension during the period of study. CONCLUSIONS The results of our study indicate that nifedipine is as effective as methyldopa in the treatment of PIH.