Abstract: The objectives of the study were: a) To identify the different risk factors in Early onset Preeclampsia. b) To study the Fetomaternal outcomes in that group. This was a one year cross-sectional study conducted in the Department of Obstetrics and Gynaecology at Gauhati Medical College and Hospital.100 mothers with Early onset Preeclampsia (EO-PE) (<34 weeks of gestation) were taken. Data about maternal risk factors, maternal complications, foetal and neonatal outcome were analysed and statistical significance determined. Primiparity, increasing BMI, family history of preeclampsia and male sex of the foetus were found to be important risk factors in development of EO-PE. All the maternal complications like eclampsia, sepsis, systemic disorders, ICU admissions and maternal deaths were higher in EO-PE. Greater number of patients with EO-PE progressed to develop severe preeclampsia. The rate of neonatal complications like abnormal umbilical artery Doppler, low birth weight, reduced APGAR score was higher in EO-PE. Incidence of NICU admissions and neonatal/perinatal deaths was also noted to be higher in EO-PE. Classification of preeclampsia into early and late onset has both etiological and prognostic value. Early detection, close monitoring, timely intervention by the obstetrician and good neonatal care by the paediatrician is the key for successful outcome in Early onset preeclampsia.