Background information: Pre-eclampsia is a disease process of unknown etiology. It is a common complication of pregnancy, and major contributor to maternal and perinatal morbidity and mortality. Endothelial cell dysfunction plays an important role in the pathophysiology of the disease. Lactate dehydrogenase, a predominantly intracellular enzyme is a useful biochemical marker for predicting the occurrence, severity of disease, maternal and neonatal outcomes in patients with pre-eclampsia. Objective: To serially monitor LDH levels in a cohort of normotensive pregnant women with risk factors for pre-eclampsia. Evaluate for possible correlation between the concentrations of LDH with occurrence and severity of pre-eclampsia, as well as maternal and neonatal outcomes. Methodology: The study was conducted between 1st September, 2015 and 31st January, 2018. Participants were one hundred and fifty four (154) normotensive, at-risk, pregnant women before or at 20 weeks gestation. All participants had baseline serum LDH measurements at 20th week, with serial follow up measurements every four weeks (i.e. 24, 28, 32 and 36 weeks of gestation), and at delivery. Blood pressure measurement and urinalysis were done with each LDH measurement, with the aim of making a diagnosis of pre-eclampsia. Participants were categorized, based on the results into those who subsequently developed pre-eclampsia and those who remained normotensive. Attention was paid to relationship of LDH with occurrence and severity of preeclampsia. All participants were evaluated for maternal and neonatal outcomes. Analysis for LDH was done with Agappe serum LDH kit. Data was analyzed using IBM SPSS Statistics 20.0 (IBM, Armonk, NY, USA). Descriptive analyses of normally-distributed numeric variables were carried out using their mean and standard deviations (Mean ± SD). Categorical variables were summarized and presented on frequency tables with simple proportions and charts as appropriate. The level of statistical significance was determined at p-values less than 0.05.