osterior reversible encephalopathy syndrome (PRES) is a rare clinical‑neuroradiological syndrome characterized by headache, seizures, disturbance of consciousness, and visual changes. Patients with risk factors, including massive blood transfusion, immunosuppressive drugs, low intracranial pressure, and perioperative hypertension, should be alert to the possibility of PRES. We presented a patient with no history of hypertension with seizures and loss of consciousness after a massive perioperative blood transfusion and two‑stage gynecological surgeries under general anesthesia. Magnetic resonance imaging confirmed a diagnosis of posterior reversible encephalopathy syndrome. Through literature review, a total of 29 perioperative PRES cases, including the present one, have been reviewed. Among the cases, 14 of 29 were female, 23 patients (79.3%) developed intraoperative or postoperative hypertension， and the mean onset of neurological symptoms after the operation was 5.4 days. Effective perioperative blood pressure management, avoiding massive blood transfusion, and early diagnosis and treatment of PRES help prevent the occurrence and development of this disease, promoting early rehabilitation and reducing the mortality and the incidence of sequelae.