BACKGROUND፡ Hypertensive disorders of pregnancy are multisystem diseases that increase the risk of adverse perinatal outcomes worldwide. It Led to early and late serious health consequence on the baby, with a significant proportion occurring in low-income countries. Hence the objective of this study was to determine perinatal outcomes and associated factors among women with hypertensive disorders of pregnancy delivered in Jimma zone hospitals.METHOD: A Facility based cross-sectional study design was employed from March to May 2020 on 211 hypertensive women delivered in the four randomly selected hospitals. The data were collected by reviewing medical record and face to face interview using consecutive sampling technique. Binary and multivariable logistic regression was performed to identify association.RESULT: Ninety-one (43.1%) of fetuses developed unfavorable perinatal outcome. Inability to read and write (AOR=2.5; 95% CI:1.03-6.17), being primipara (AOR=4.6; 95% CI:1.6-13.2) and multi-para (AOR=3.1; 95% CI:1.09-9.17), Lack of antenatal care visit (AOR=4.2; 95% CI:1.2-15.01), having preeclampsia (AOR=4.2; 95% CI:1.1-16.6) and eclampsia (AOR=5.8; 95% CI:1.2-26.2) and late provision of drug (AOR=3.9;95% CI:1.9-7.9) were independent factors.                                                                                                                  CONCLUSION: Pregnancy complicated with hypertensive disorders was associated with increased unfavorable perinatal outcomes. Preeclampsia and eclampsia, inability to read and write, primipara and multipara, lack of antenatal care and late provision of drug were factors associated with unfavorable perinatal outcomes.KEYWORDS: Perinatal outcomes, Hypertensive disorders of pregnancy, Jimma.