Acute kidney injury (AKI) in pregnancy is a rare but potentially lethal complication with often disastrous consequences for both the mother and child. It is largely a preventable entity if regular antenatal care is provided and potentially responsible obstetric complications are recognised early. The incidence and mortality rates associated with obstetric AKI (also known as pregnancy related AKI, PR–AKI) have decreased over the last few decades , more in the developed world and are gradually reducing in the developing countries as well. In 2013, the International Society of Nephrology (ISN) put forth the human rights statement of 0 by 25 stating the objective of no one dying of untreated AKI in low resource regions by 2025 with an emphasis on resource poor countries in Africa, Asia and Latin America. This will require a concerted effort and enough resource mobilization and training of involved personnel. The prevailing incidence of PR–AKI in developed countries ranges from 1 in 10,000 to 20,000 pregnancies. In recent reports, published from the Indian subcontinent , the frequency of obstetric AKI has been reported to be varying between 4–15% and has been consistently showing a downward trend. Along with a decline in the incidence, there has also been a shift from septic abortion associated AKI to that associated with pre–eclampsia and puerperal sepsis. We aimed to review this changing scenario of PR–AKI over the last two decades with published data from Asia