Pregnancy-related acute kidney injury (PrAKI) is acute kidney injury (AKI) occurring during gestation or within six weeks postpartum. It’s contributing to maternal and fetal morbidity. Studies on PrAKI in Indonesia are limited. This study aims to assess clinical profiles and maternal-fetal outcomes of patients with PrAKI admitted to Hasan Sadikin Hospital in Bandung. This retrospective cohort study examined medical records of patients hospitalized for pregnancy-related AKI from October 2019 to October 2024. Data included sociodemographic, clinical, and obstetric characteristics, laboratory results, causes, comorbidities, and outcomes. Descriptive analyses evaluated clinical characteristics, while the Kruskal-Wallis test and ANOVA identified differences among variables. Logistic regression calculated odds ratios for dependent variable relationships. Out of 12,223 patient admissions, 102 cases of PrAKI were identified, yielding an incidence rate of 0.83%. I. Hypertensive disorders in pregnancy, particularly Eclampsia and Preeclampsia, were identified as the most prevalent etiologies, accompanied by chronic hypertension and chronic kidney disease as significant comorbidities. Hemodialysis was necessitated in 22.5% of cases, with 29.5% requiring intensive care unit (ICU) treatment and 24.5% of patients necessitating ventilatory support; moreover, vasoactive agents were administered to 7.8% of the cohort. (p<0.001). Mortality rate of 26.5%, with only 57% of neonates being born alive. Further multivariate analysis revealed that the risk of mortality was significantly heightened in patients classified in AKI stage III, with an odds ratio (OR) of 2.96 (95% [CI] 1.21-7.24). Additionally, the presence of metabolic acidosis (OR 12.00 [CI 2.32-62.17]), loss of consciousness (OR 0.20 [CI 0.13-0.30]), hemorrhagic events (OR 5.15 [CI 1.14-23.21]), and sepsis (OR 13.13 [CI 3.74-46.05]) were identified as significant risk factors associated with increased mortality in this patient population. This investigation elucidates distinct clinical manifestations compared to other developing nations, specifically regarding Eclampsia and Pre-eclampsia as a primary cause, with a maternal mortality rate quantified at 26.5%.