Background: Preeclampsia presents substantial dangers to the health of both mother and child, calling for accurate indicators of potential negative consequences. Using the middle cerebral to uterine artery pulsatility index ratio, this research sought to predict foetal and neonatal outcomes in women with preeclampsia. The purpose of this prospective study was to examine the relationship between foetal and neonatal outcomes and pulsatility index ratios in fifty preeclamptic patients utilising Doppler tests and other evaluations. To find out if there was a correlation between normal and abnormal ratio cases and factors like foetal weight, gestational age, intrauterine growth restriction (IUGR), preterm labour, caesarean section (CS), Apgar scores, and admissions to the Neonatal Intensive Care Unit (NICU), statistical analyses were performed. The results showed that in preeclampsia cases, around 40.4% had aberrant middle cerebral to umbilical artery ratios (