BACKGROUND Nifedipine is widely used for acute lowering of blood pressure in obstetric hypertensive emergencies. It has not been approved for this indication or widely assessed. OBJECTIVE To examine retrospectively the efficacy of nifedipine over a 12 month period in a high risk obstetric service. METHODS Chart review of all patients admitted to hospital in the antenatal period with moderate to severe hypertension. Description of their management, usage of nifedipine, and pregnancy outcome. RESULTS Sublingual nifedipine resulted in significant lowering of blood pressure without hypotension. Pregnancy outcome was satisfactory in all patients. CONCLUSIONS Sublingual nifedipine was effective, easy to administer, and without serious complications in this retrospective study.