Hypertensive disorders of pregnancy (HDP), including chronic hypertension, gestational hypertension, pre-eclampsia, eclampsia, and HELLP syndrome, are major contributors to adverse maternal and neonatal outcomes. However, epidemiological data from the United Arab Emirates (UAE) remain limited. This study aimed to investigate the prevalence and clinical characteristics of HDP in a large tertiary center, providing evidence from an underrepresented region and a basis for future studies. This six-year retrospective cohort study (2018–2023) was conducted at a tertiary referral center in Dubai, UAE. HDP cases were identified from electronic medical records using ICD-9/10 codes among all deliveries. Maternal and neonatal outcomes were compared by HDP status and World Health Organization (WHO) regions. Multivariate logistic regression was used to identify factors independently associated with HDP. P < 0.05 was considered significant. Among 21,415 deliveries, HDP prevalence was 4.7% (n = 1,011), while pre-eclampsia prevalence was 2.3%. In multivariable logistic regression, increasing maternal age [OR 1.10 (1.08–1.12)], BMI [OR 1.06 (1.05–1.07)], diabetes [OR 2.31 (1.78–3.00)], renal disease [OR 5.41 (3.12–9.36)], and origin from the Western Pacific Region [OR 1.94 (1.46–2.58)] were independently associated with HDP. Increasing gravidity was associated with lower odds of HDP [OR 0.90 (0.87–0.93)]. Women with HDP delivered earlier, had lower Apgar scores, and had more caesarean delivery. No significant difference in HDP prevalence occurred between UAE nationals and non-UAE nationals. HDP prevalence varied across WHO regions, ranging from 4.3% in the South-East Asian region to 9.1% in the Western Pacific region. In this large multi-ethnic UAE cohort, HDP affected 4.7% of pregnancies and showed regional variation. This study provides one of the first UAE-based estimates of HDP prevalence. Despite prevalence within global estimates, HDP remains a significant public health burden. Strengthened screening and preventive strategies are needed to improve maternal and neonatal outcomes.