Background: Pregnancy complications or problems at delivery or during the neonatal period can lead to severe maternal or infant morbidity. Hyperhomocysteinaemia may be an important marker for, and possibly a cause of or contributor to complications of an adverse outcome of pregnancy. This is thought to be mediated through faulty early placentation involving trophoblastic invasion and angiogenesis. Objectives: This study was aimed to determine the prevalence of hyperhomocysteinemia among pregnant women in early pregnancy and its association with development of preeclampsia and other adverse pregnancy outcomes (preterm birth, low birth weight and stillbirth). Methods: This study was longitudinal study which involved 167 pregnant women with serum homocysteine samples collected between 8 and 12weeks gestation and analysed by ELISA and pregnancy outcomes retrieved from their birth records.