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Background: Hypothyroidism is common in Iran and preeclampsia is a pregnancy complications. Hypothyroidism has autoimmune base and one of the pathogenesis of preeclampsia is autoimmune disorder. This study aimed to evaluate the relationship between hypothyroidism and preeclampsia in pregnant women. Methods: This analytic descriptive cross-sectional study was done in Shahid Beheshti university hospital in Isfahan, Iran, in 2016. Simultaneously existence of hypothyroidism and preeclampsia and severity of preeclampsia and gestational age of pregnancy in time of delivery were evaluated in 298 pregnant women. Findings: The prevalence of preeclampsia in was 9.3% and 23.1% in euthyroid and hypothyroid women, respectively (P = 0.002) and a significant relationship was between hypothyroidism and severity of preeclampsia (P = 0.003). Preterm delivery was seen in 18.4% and 25.0% of euthyroid and hypothyroid women, respectively. However, preterm delivery was more in hypothyroid women; but there was no significant correlation between hypothyroidism and time of delivery (P = 0.440). There was no correlation between hypothyroidism and body weight (P = 0.410). First minute Apgar score in neonates of hypothyroid women was less than neonates of euthyroid women (P = 0.047); but fifth minute Apgar score had no significant difference (P = 0.110). Conclusion: This study showed that hypothyroidism can increase the risk of creation and severity of preeclampsia. So, diagnosis and treatment of hypothyroidism can decrease complications of pregnancy such as preeclampsia.