Objective: To improve the quality of clinical care for women with severe pre-eclampsia. Methods: A criteria-based audit was conducted in a large government hospital in Uganda. Management practices were evaluated against standards developed by an expert panel by retrospectively evaluating 43 case files. Results of the audit were presented, and recommendations developed and implemented. A re-audit was conducted 6 months later. Results: The initial audit showed that most standards were rarely achieved. Reasons were discussed. Guidelines were produced, additional supplies were purchased following a fundraising effort, labor ward procedures were streamlined, and staffing was increased. In the re-audit there were significant improvements in diagnosis, monitoring, and treatment. Conclusion: Criteria-based audit can improve the quality of maternity care in countries with limited resources. Objective: To improve the quality of clinical care for women with severe pre-eclampsia. Methods: A criteria-based audit was conducted in a large government hospital in Uganda. Management practices were evaluated against standards developed by an expert panel by retrospectively evaluating 43 cases Results of the audit were presented, and recommendations developed and implemented. A re-audit was conducted 6 months later. Results: The initial audit showed that most standards were rarely achieved. following a fundraising effort, labor ward procedures were streamlined, and staffing was increased. In the re-audit there were significant improvements in diagnosis, monitoring, and treatment. Conclusion: Criteria-based audit can improve the quality of maternity care in countries with limited resources.