AbstractIntroduction: Preeclampsia is a multisystem disorder that associated with significant maternal and neonatal morbidity and mortality. Hyperuricemia has been linked with preeclampsia hemce having a predictive role in perinatal outcome. Objectives: Objective was intended to study uric acid as an important biomarker in early identification and measurement of severity of preeclampsia and prediction of maternal and perinatal complication. Material and Methods: A prospective observational antenatal control study was done at GMCH Udaipur, Rajasthan from January 2018 to July 2018. Total no. of 191 patients with PIH were included in our study. Maternal outcome noted in the terms of the mode of delivery, maternal complications and maternal end result. Fetal outcome assessed by perinatal morbidity and mortality, need for admission in NICU and neonatal end result. Patients were divided into two groups according to the level of uric acid. Patients with uric acid <5.0 mg/dl and >5.0 mg/dl. Results: Out of 191 patients, 39 (20.52%) patients with mild preeclampsia, 24 (12.56%) with moderate preeclampsia and 6 (3.14%) with severe preeclampsia while 3 (1.57%) patients had eclampsia. All the patients with Severe pre eclampsia and eclampsia and majority of moderate preeclampsia had uric acid >5 mg/dl (p value <001). In which higher level of mean of uric acid level in severe preeclampsia (8.67 ± 2.32) and eclampsia (10.37 ± 4.85) have been noted in our study. Majority of maternal as well as fetal complicatios have been noticed in patients with uric acid levels >5 mg/dl. Majority of low birth weight and NICU admissions were also seen in uric acid levels >5 mg/dl. Conclusion: The presence of hyperuricemia, especially >5 mg/dl levels identifies PIH patients at increased risk of maternal and fetal complications. By serum uric acid laboratory test, the severity of the disease can be predicted with more accuracy timely intervention gives us better perinatal outcome.