A hydraulic shock absorber includes a piston, a damper tube, a suspension spring, a plunger, a jack chamber, a pump case, a pump piston, a screw shaft, and a drive unit. Both end surfaces of the pump piston in a reciprocating direction are a first end surface demarcating the pump chamber, and a second end surface demarcating the gas chamber, the second end surface having a screw hole into which the screw shaft is screwed. The pump piston includes a space portion between a bottom plate defining the first end surface and the screw hole. The screw shaft has a through-hole connecting the gas chamber with the space portion.