Context: Preeclampsia and eclampsia are common complications of pregnancy with attendant adverse maternal and fetal outcome. Studies done in different parts of the world had indicated that the pathology is at the placental bed. However, no such study has been published from our area. Objective: To determine the pattern of placenta histopathological changes in preeclampsia and eclampsia among Nigerians in Irrua, and correlate these with the clinical severity as well as the maternal and perinatal outcome. Design: One point descriptive cross sectional study. Setting: Department of Obstetrics and Gynaecology, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria. Subject: Placental pathologies were evaluated in thirty-three preeclamptic and five eclamptic patients and were compared with forty women (matched for age, parity and gestational age) without pregnancy complications as control. Result: Preeclampsia and eclampsia were associated with significant placental infarcts with about 40% of maternal surface area affected in 60% of patients. Placental stromal fibrosis (79 %) and acute atherosis (74%) were the more consistent histopathological findings with severe disease (p< 0.05, 0.001 respectively). Histopathological lesions has no direct correlation to the clinical severity ( proteinuria p< 0.6385, blob pressure p< 0.0743). Conclusion: Preeclampsia and eclampsia in Nigerians at Irrua are associated with similar placental changes as in other parts of the world. Histopathological lesions were worse with severe disease, however, the lesions were much less severe compared to those in western countries.