To assess the potential of the hand-grip exercise test as a screening test for pregnancy-induced hypertension a prospective non-interventional study was carried out in a teaching hospital antenatal clinic. The hand-grip test was performed on 200 nulliparous, normotensive subjects at 28-32 weeks gestation. The main outcome measurement was the subsequent development of pregnancy-induced hypertension or pre-eclampsia. The sensitivity of the technique in predicting pregnancy-induced hypertension was 53% and the specificity was 94%. The sensitivity of the test in predicting pre-eclampsia was 80% and the specificity was 92%. The time-consuming nature of the hand-grip test probably restricts use of the technique to research studies where selection of a high-risk group is required.