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WHAT IS KNOWN AND OBJECTIVE: Pre-eclampsia is one of the most challenging diseases of pregnancy. Both nifedipine and labetalol have been used for treatment of pregnancy-induced severe pre-eclampsia. METHODS: In the present study, the efficacy and safety of oral nifedipine and intravenous labetalol for severe pre-eclampsia therapy were compared. Eligible pregnant women with severe pre-eclampsia (n = 147) were allocated to receive either oral nifedipine or intravenous labetalol. The primary endpoint of the study was the time needed to achieve target blood pressure. Secondary outcomes were the time interval before a new hypertensive crisis following effective blood pressure control, number of doses and adverse effects. RESULTS AND DISCUSSION: We found that the time taken to achieve effective blood pressure control was 35 vs. 42 min for oral nifedipine and intravenous labetalol, respectively (P = 0·37). Compared with labetalol group, no significant difference was observed regarding time interval and drug dosages in nifedipine arm. Moreover, no serious side effects on maternal or perinatal were observed in either group. WHAT IS NEW AND CONCLUSIONS: These findings suggest that both oral nifedipine and intravenous labetalol are effective for safely reducing blood pressure to target levels in patients with severe pre-eclampsia.