The aim of this work is to describe understandings of pre-eclampsia among community members in two representative districts of Karnataka State, India. This includes use of local terminology, knowledge of causes, danger signs, outcomes, as well as practices related to prevention and treatment in the home. Background: Despite global efforts, the rates of maternal mortality remain unacceptably high in less developed countries. To reduce the number of morbidities and mortalities it is critical to understand any given community’s perceptions of pregnancy and its complications.The study was conducted in Karnataka State, India in 2013. The study was designed to examine perceptions of pre-eclampsia using 14 focus group discussions with community stakeholder groups: community leaders (N=27), male decision-makers (N=19), female decision-makers (N=41), and women of reproductive age (N=132).Although local terminology exists to describe convulsions and hypertension they are not specific to pregnancy. The community’s perceived causes of eclampsia included: anemia, lack of medical adherence, not receiving tetanus toxoid injections and exposure to fire or water in pregnancy. Stress and tension along with a poor diet were felt to be responsible for the onset of pre-eclampsia. While the danger signs of eclampsia were not well known, there was a sense that sweating, tiredness, giddiness, swelling, and irritability are signs of pre-eclampsia. Folk remedies are still used for the treatment of seizures, such as providing the smell of onion, placing keys or iron in the hands, and squeezing the fingers and toes.Improvements in maternal and perinatal health require strategies that involve the community and reflect their knowledge, attitudes and practices. Advocacy and educational initiatives should target knowledge gaps and incorporate cultural understandings of disease. This study achieved its aim of describing the knowledge, attitudes, and practices related to pre-eclampsia and eclampsia among communities in Karnataka State.M. Vidler: None. U. Charanthimath: None. G. Katageri: None.U. Ramadurg: None. C. Karadiguddi: None. D. Sawchuck: None. R. Qureshi: None. S. Dharamsi: None. P. von Dadelszen: None. R. Derman: None. S. Goudar: None. A. Mallapur: None. M. Bellad: None.