Thrombotic microangiopathies (TMAs) that occur during pregnancy or the postpartum period—including preeclampsia/HELLP syndrome (hemolysis, elevated liver enzymes, low platelets), thrombotic thrombocytopenic purpura (TTP), and atypical hemolytic uremic syndrome (aHUS)—present a diagnostic challenge due to their overlapping clinical features. We report a case of a 21-year-old primigravida of African origin who developed the HELLP syndrome followed by postpartum aHUS. The clinical course was marked by thrombocytopenia, hemolytic anemia, acute kidney injury, and massive proteinuria.