Background: Preeclampsia [PE] is one of the commonest medical emergencies. It had high morbidity for the mother and her infant. Early diagnosis could reduce such morbidity. Aim of the work:To evaluate the role of maternal serum placental protein [PP13] levels and uterine artery Doppler in early prediction and prognosis of preeclampsia. Patients and Methods:The study included 60 pregnant women in their first and early second trimester with high risk for preeclampsia. Patients were divided into three groups: control, mild and sever preeclampsia. All were subjected to proper history taking, clinical and obstetrical examination, laboratory investigations and ultrasound examination. Results: Cesarean delivery was significantly increased in preeclampsia compared to controls [55% of mild and 20% of severe disease compared to 15% of controls]. Both uterine artery resistance index [RI] and pulsatility index [PI] were significantly increased in PE when compared to control and in severe when compared to mild PE groups. Finally, PP13 was significantly decreased in patients with severe PE [171.7±35.9] when compared to mild PE [213.1±41.8] or control group [254.8±51.1]. In addition, there was significant decrease in cases with mild PE when compared to control group. Finally, there was inverse [negative], moderate and statistically significant correlation between PP-13 from one side and each of systolic BP, diastolic BP, uterine artery RI and PI. In addition, both RI and PI were proportionally correlated with PI and RI. Conclusion:The present study showed that PP13 combined with PI or RI can predict PE with a good sensitivity and specificity.