HELLP syndrome (Hemolysis, Elevated Liver enzymes, and a Low Platelet count) is a severe complication of preeclampsia or eclampsia, and is associated with a high risk of maternal and neonatal morbidity and mortality. In cases of delivery management in patients with HELLP syndrome, general anesthesia is required for cesarean sections in the presence of severe thrombocytopenia. These patients have a high risk of uncontrollable hypertension under stressful conditions, such as laryngoscopic intubation, surgical incision, and delivery. Remifentanil is an ultra-short-acting opioid with rapid onset and offset of action. In addition, remifentanil has a potent analgesic effect and provides cardiovascular stability during surgery. This paper reports a 33-year-old patient with HELLP syndrome, who was referred to our hospital for a cesarean section. The procedure was performed under general anesthesia with remifentanil being used as an adjunct for cardiovascular stability.