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Introduction : Wernicke's encephalopathy is a rare but severe neurological disorder caused by thiamine(vitamin B1)deficiency, which can complicate hyperemesis gravidarum in pregnancy, leading to significant maternal morbidity if not treated early. Aims & Objectives : This case highlights the importance of early recognition and treatment of Wernicke's encephalopathy in pregnant women with hyperemesis gravidarum, aiming to reduce neurological complications through timely thiamine supplementation and supportive care. Case Report : A 22-year-old pregnant woman presented with severe hyperemesis gravidarum, persistent vomiting, altered sensorium, ataxia, and ophthalmoplegia. Clinical suspicion of Wernicke's encephalopathy was supported by MRI findings showing characteristic lesions. Immediate intravenous thiamine therapy was initiated, alongside supportive hydration and nutrition. Rapid clinical improvement was observed after initiating thiamine, with resolution of ataxia and ophthalmoplegia within days. This case highlights the importance of early diagnosis and prompt thiamine supplementation in preventing irreversible complications. Conclusions : Wernicke's encephalopathy in pregnancy, though rare, necessitates high clinical suspicion in cases of prolonged hyperemesis gravidarum. This report emphasizes the importance of timely thiamine therapy in improving maternal outcomes and preventing neurological sequelae. Awareness and education about this preventable condition are essential for better patient care.