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ABSTRACT Objective: to identify the socio-demographic and other risk factors associated with pre-eclampsia, eclampsia and its adverse outcomes in low- and middle-income pregnant females. Methods: This cross-sectional study was conducted at three tertiary care hospitals of Peshawar Pakistan, on 113 pregnant women (43 with pre-eclampsia, 37 with eclampsia and 33 without pre-eclampsia/eclampsia). Data was collected by interviewing study subjects using a pre-tested questionnaire incorporating important risk factors of pre-eclampsia and eclampsis. Data was analyzed using SPSS. Results: Majority (89.4%) of women were >20 years of age. Out of 113 study participants, 78(69.02%) were from low-income (Rs<8500) and 35 (30.98%) were from middle-income (Rs= 8501-103900) group. Thirty one (83.78%) patients of eclamptia, 32 (74.42%) of pre-eclampsia and 15 (45.45%) normotensive pregnant women were from low-income group (p<0.01). Forty-nine of 113 (43.3%) antenatal women had no antenatal visits and 48 (42.5%) had 1-3 antenatal visits. About half of women with low-income (n=40/78, 51.3%) had no antenatal visits as compared to middle-income (n=9/36; 25.7%). Out of 49 women with no antenatal visits, 23 (46.94%) were eclamptic, 25 (51.02%) were having pre-eclampsia and 1 (2.04%) was normotensive. In this study, 23/37 (62.26%) of eclampsia, 25/43 (58.14%) of pre-eclampsia and 1/33 (3.03%) of normotensive pregnant women had no antental visits. Twenty (17.7%) antenatal women had history of >2 still-births and majority (n=16/20; 80%) were from low-income group. Conclusion: Lower class socio-economic status and lack of antenatal visit are associated with  pre-eclampsia and eclampsia and related adverse outcome. Interventions at primary care level are in need. Keywords: Pregnancy Outcome (MeSH), Eclampsia (MeSH), Pre-eclampsia (MeSH), Pregnancy (MeSH), Hypertension (MeSH), Low Income Population (MeSH), Poverty (MeSH)