Objective: To identify preoperative risk factors associated with pulmonary hypertension (PAH) crisis in pregnant women undergoing cesarean section and to explore implications for physical recovery, resilience, and postpartum rehabilitation. Methods: A retrospective analysis was conducted on 120 pregnant women with PAH who underwent cesarean delivery between January 2015 and December 2022. Patients were divided into two groups: those who experienced a PAH crisis during the preoperative period (n=40) and those who did not (n=80). Clinical and demographic data, including age, body mass index (BMI), PAH classification, echocardiographic parameters, functional capacity (New York Heart Association classification), and comorbidities, were collected. Logistic regression analysis was performed to identify independent preoperative risk factors for PAH crisis. Recovery metrics, including duration of hospitalization and postpartum physical activity levels, were also assessed. Results: Significant preoperative risk factors for PAH crisis included advanced maternal age (OR = 1.45, 95% CI: 1.10–1.89, P < 0.01), higher BMI (OR = 1.38, 95% CI: 1.12–1.71, P < 0.01), severe PAH classification (OR = 2.25, 95% CI: 1.43–3.55, P < 0.001), and reduced functional capacity (OR = 1.58, 95% CI: 1.18–2.13, P < 0.01). Echocardiographic findings of elevated pulmonary artery pressure and right ventricular dysfunction were also significant predictors (P < 0.05). Patients who experienced a PAH crisis had longer hospital stays and lower postpartum physical activity levels, highlighting the impact on recovery and physical resilience. Conclusion: Advanced maternal age, higher BMI, severe PAH classification, and reduced functional capacity are key preoperative risk factors for PAH crisis in pregnant women undergoing cesarean delivery. Addressing these factors through optimized perioperative care and individualized rehabilitation strategies is crucial for improving maternal outcomes. Incorporating early postpartum physical activity and rehabilitation programs may enhance recovery and resilience, enabling women to regain functional independence and improve their overall quality of life. Further research should explore the integration of exercise-based interventions in the management of PAH during pregnancy and postpartum recovery.