Background: Pre-eclampsia is a multi-systemic disorder which is associated with pregnancy. It accounts for about 15% of maternal morbidity and mortality and it’s a major cause of iatrogenic pre-term delivery and low birth weight babies. The diverse multi-systemic symptoms of preeclampsia have made it difficult to define this disease condition and to identify a specific causative agent for the symptoms. Although the clinical signs of pre-eclampsia can occur at any stage from late mid-trimester, the initiation of the process begins soon after conception. One of the identified pathophysiology of pre-eclampsia is deranged serum lipid profile, which has been shown to be elevated early in pregnancy in patients that are destined to develop pre-eclampsia. Therefore, the aim of this study was to find out whether the deranged lipids in primigravidae can be used to predict the occurrence of pre-eclampsia among primigravidae. Objective: To compare the fasting serum lipid profile of healthy and pre-eclamptic primigravidae with the aim of using the association between pre-eclampsia and altered serum lipid metabolism to predict the occurrence of pre-eclampsia among primigravidae. Study Design: A nested case-control study. Methods: A total of 138 primigravidae were recruited into the study. Their anthropometric data were taken at booking. 5ml of peripheral blood specimens for fasting serum lipid profile were collected from all the patients after an over-night fasting for at least eight hours at gestational ages 20, 28, and 34 weeks. All the patients were followed up with blood pressure and urinalysis done at every antenatal clinic visit.