Hypertension is one of the most common medical conditions complicating pregnancy, with significant implications on maternal and perinatal morbidity and mortality. Abnormalities in placentation have been implicated as the primary pathology responsible for the development of hypertension during pregnancy and its effects such as pre-eclampsia and eclampsia. With advancing research, the focus is now gradually shifting towards abnormalities in the maternal vasculature, including endothelial damage/dysfunction and impaired repair as a probable cause for this, with the latter being implicated in the development of cardiovascular disorders in later life in these women. Circulating endothelial cells (CECs) are a novel means of assessing endothelial dysfunction are mature cells detached from the vascular intimal layer in response to a variety of insults. Endothelial progenitor cells (EPCs) are non-leukocyte cells derived from the bone marrow with proliferative potential that may be important in vascular regeneration. This review article aims to provide an overview of current literature and concepts relating endothelial damage/dysfunction and impaired repair and the hypertensive disorders in pregnancy, with particular focus on CECs and EPCs.