Background: Preeclampsia is a condition unique to pregnancy, which can lead to significant maternal and fetal morbidity and death. Early detection of women at greater risk of preeclampsia helps avoid and treat early illness. Aim of the work: current study aimed to compare the performance of the NICE guidelines, the ACOG recommendations and (FMF) algorithm for the early detection of preeclampsia. Patients and Methods: Current study was a cohort prospective study included 400 women who attended for their routine antenatal care during the second trimester. All demographic and clinical data and follow up cases collected. Results: The incidence of preeclampsia was 9.3%. There was a significant older age (28.89±2.74 vs 27.55±2.88) and increase in patient weight, height and BMI among PE cases. Also, there was a statistical significant raising in the cesarean section mode of delivery (45.9% vs 26.4%), ovulation induction (24.3% vs 6.1%) and high mean of arterial pressure (113.46±2.34 vs 92.09±2.98 mmHg), and Doppler ultrasound, the uterine artery pulsatility index (PI) (1.05±0.30 vs 0.55±0.14) among PE cases. On the other hand, there was a statistical significant decrease in fetal GA at delivery (37.0±1.49 vs 38.19±1.10 weeks), decrease of fetal birth weight, Apgar score at first and fifth minutes among females developed PE. Conclusion: Screening for early preeclampsia in second trimester using maternal history, mean arterial pressure and mean uterine artery Doppler pulsatility index (FMF algorithm) was better than screening by maternal characteristics alone (NICE and ACOG guidelines).