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Introduction Despite development of various prediction models, pre-eclampsia continues to be a major contributor to maternal mortality and morbidity. Assuming that raised serum lactate is a marker of tissue hypoperfusion and hypoxia as associated with preeclampsia, it can be used as a successful biomarker in prediction of maternal complications and aid in successful management of preeclampsia and thus improve maternal and perinatal outcome. Aims & Objectives ? To evaluate the association of serum lactate concentration with severity of pre-eclampsia and maternal complications. Materials & Methods This study was conducted in KLE?s Dr Prabhakar Kore Hospital, Belagavi. Study design ? Observational study Study period ? January 2020 to September 2021 Sample size ? 170 ? All patients fulfilling the criteria for pre-eclampsia and eclampsia were included in the study. Baseline characteristics were noted and serum lactate was collected at the time of admission. Serum lactate >27 mg/dl was considered high. Participants were evaluated for development of complications ? Stroke, PRES, HELLP, DIC, Abruption, Pulmonary edema and Acute kidney injury. Results 170 participants were analysed in the study. The mean lactate level observed was 40.5 ? 24.8 mg/dl. The serum lactate level was significantly higher in eclampsia than preeclampsia (p=0.03). Maternal complications were noted in 50% of the study participants with 21% having CNS complications. Of these, 77.7% women had lactate >27 mg/dl, although not found statistically significant. Statistical significance was found only when associated with HELLP with 80% having lactate >27 mg/dl (p=0.03). Conclusion Serum lactate is a major predictor of severity of pre-eclampsia. In case of pre-eclamptic patients presenting with maternal complications, serum lactate levels were elevated although no statistical significance could be established.