Background. The roll-over test is a simple, easily available clinical test using the sphygmomanometer to predict pregnancy-induced hypertension starting at 20 weeks age of gestation (AOG). However, the roll-over test is not part of the standard prenatal care in government health facilities even if health workers can easily perform the test. Objectives. To validate the roll-over test at the 20th weeks of gestation and to determine the risk factors for preeclampsia in 4 health districts of Surigao City, a province in the CARAGA Region of the Philippines. Methods. A total of 190 pregnant women without history of hypertension during their previous pregnancies from 4 health districts in Surigao City, Philippines were consecutively enrolled from May 2014 to October 2014 in a cross-sectional study design. The roll-over test was done using the method described in Williams Obstetrics and the validity of the roll-over test was measured. Bivariate and multivariate analyses were done to determine risk factors for preeclampsia. Results. Seven of the 190 women developed preeclampsia. The sensitivity of the rollover test done at 20 weeks AOG was 43% and the specificity was 81%. Maternal age, history of urinary tract infection (UTI) and a positive rollover test were associated with preeclampsia. Conclusion. Pregnant women whose ages are <20 years or >29 years old, or who had a history of UTI, or a positive roll-over test are more likely to develop preeclampsia. Roll-over test has a low sensitivity at 20 weeks AOG. More studies are warranted to explore the improvement of its predictive value in other AOG.