Background <p>Maternal hypertensive disorder seriously threatens maternal and neonatal health, contributing to high morbidity and mortality globally. Existing studies on its burden have limitations, like limited data periods or a lack of focus. There’s a need for a comprehensive analysis.</p> Methods <p>This study utilized GBD 2021 data to systematically evaluate the global, regional, and national burden of Maternal hypertensive disorder from 1990 to 2021. It assessed deaths and Disability-Adjusted Life Years, explored temporal trends with linear regression, analyzed regional patterns via cluster analysis, identified burden change drivers using decomposition analysis, estimated achievable outcomes through frontier analysis, and predicted future trends with the Bayesian model for age-period-cohort for better public health planning.</p> Results <p>From 1990 to 2021, the global age-standardized incidence, prevalence, mortality, and Disability-Adjusted Life Years rates of Maternal hypertensive disorder decreased to 227.96,44.42,0.48, and 31.29 per 100,000, respectively. Based on Bayesian model for the age-period-cohort projections, they will continue to decline to 2046. However, there were marked disparities. Low-Socio-Development Index regions had a heavier burden, and some regions like parts of Latin America &amp; Caribbean saw an increase, while East Asia had a decrease. Aging, population growth, and epidemiological changes had different effects on the burden across regions.</p> Conclusions <p>This study suggests that targeted public health policies are essential. Low-income regions must enhance healthcare infrastructure and promote family planning, while high-income areas should focus on the aging maternal population. However, the study has limitations concerning data accuracy and model assumptions. Future research should strive to improve data quality and analytical models to better address maternal health disparities and enhance maternal health outcomes.</p>