Introduction: Acute fatty liver of pregnancy (AFLP) is a rare, but potentially fatal condition, characterized by hepatic failure typically in the third trimester of pregnancy that is associated with multiorgan involvement resulting in several clinical and laboratory abnormalities. Aim and Objectives: To study the course of acute fatty liver of pregnancy which will help later to early diagnose, prompt delivery, and providing supportive care to improved maternal morbidity and mortality rates. Materials and Methods: The authors report an observational case series of patients who developed acute fatty liver of pregnancy and managed in critical care in a year that illustrated the compound challenges in recognition, monitoring, and management. One of the cases has been imprinted with maternal mortality because of deterioration of the condition leading to sepsis along with multiorgan dysfunction syndrome. Results: A total of three cases of acute fatty liver of pregnancy were found in a year. Nausea, vomiting, and anorexia were the most common symptoms among all. Jaundice and ascites were the most common findings. Deterioration of the condition can lead to complications like sepsis, Disseminated Intravascular Coagulation, multiorgan failure, and death. Conclusions: Early detection, delivery, and supportive care are sufficient to reduce fatality but in cases of deterioration of patients’ condition despite proper management can lead to multiple complications and ultimately mortality. Regular antenatal health check-ups can help in early detection.