Pregnancy is a condition that involves physiological changes throughout the body for the proper development of the fetus. These changes occur at various levels, including cardiovascular, respiratory, and endocrinological aspects [1], [2]. Generally, there is an increase in cardiac volume and output, an increase in inspiratory volume, and elevated hormone production such as estrogen and progesterone [3], [4].

Additionally, individuals living at altitudes above 1500 m above sea level (masl) also undergo physiological changes, including increased red blood cell production, enhanced pulmonary ventilation, alterations in blood pressure, etc. These adaptations result from acclimatization to an environment with lower oxygen pressure as altitude increases [5]. It is known that more than 400 million people reside above 1500 masl, with approximately 83 million living between 2500 and 4000 masl, including pregnant women within this population [6], [7].

Pregnant women residing at altitudes above 1500 m above sea level (masl) experience various conditions that manifest in maternal and neonatal outcomes. These include lower birth weight due to fetal growth restriction, increased maternal oxygen demand, elevated red blood cell requirements, leading to higher blood viscosity, and an elevated risk of gestational hypertension [8], [9]. Given that arterial hypertension is a shared morbidity for both pregnant women and the general population, its significance is heightened by its higher incidence at high altitudes and very high altitudes [10]. Furthermore, it stands as one of the most significant causes of maternal mortality worldwide [11].

Despite its clinical importance, the specific clinical conditions (such as signs, symptoms, complications, and laboratory results) have not been adequately addressed. Additionally, there is no consensus on diagnostic criteria for pregnant women at high altitudes experiencing gestational hypertension, in contrast to those at sea level [12]. Considering this issue, this scoping review aims to synthesize evidence regarding the clinical manifestations and complications of preeclampsia and eclampsia in pregnant women residing at high altitudes and very high altitudes. The findings could guide healthcare professionals to emphasize the care and prevention of complications in this population, potentially paving the way for the development of clinical practice guidelines in the future.