Objective: The purpose of this study was to compare adipokines' levels between women with and without preeclampsia based on maternal body mass index (BMI). Study design: This was a cross-sectional study among third-trimester pregnancies with preeclampsia (PIH) compared with normotensive controls. Serum levels of adiponectin, leptin, and resistin were measured before delivery by radioimmunoassay or enzyme-linked immunosorbent assay (ELISA). Results: The study included 22 normotensive and 77 PIH women. Leptin levels increased with maternal BMI. In patients with severe preeclampsia, overweight, and obese women had increased leptin levels (33.4 ± 14.8 vs 23.0 ± 10.8 ng/mL respectively, P = .02), and decreased adiponectin levels (8.4 ± 5.3 vs 12.6 ± 6.0 ng/mL, P = .03) compared with normal weight women. In women with BMI <25 kg/m2, adiponectin levels increased in patients with preeclampsia compared with controls (11.5 ± 5.6 vs 9.6 ± 4.6 and 7.0 ± 3.2 ng/mL, respectively, P = .005). There was no association between resistin levels and preeclampsia or maternal BMI. Conclusion: Women with severe preeclampsia and BMI ≥25 kg/m2 have decreased adiponectin and increased leptin levels, while normal weight women with preeclampsia have increased adiponectin levels.