Objective: To describe perception about severe preeclampsia and its causality in a group of women who lived the disease and were attended at Hospital de San José (Bogotá). Method: Qualitative phenomenological study. Ten puerperal women who suffered severe preeclampsia and were attended at Hospital San José (Bogotá) during 2012 participated in the study. They were selected by intentional sampling; sample size was defined by saturation criteria. Information was collected by in-depth interview and data were analyzed by Colaizzi´s proposal. Results: Participants who suffered the disease first-time perceived its onset “unexpected, without warning”; for those who did suffered it already, they awaited with resignation and anguish. Suffering was depicted from the dimensions of hazard, capability to kill and sequels after pregnancy; also, as something “alien to women´s will”, uncontrollable, causing impotence and resignation. Perception of causality showed up three elements: lack of healthcare during pregnancy, predisposition to disease and personal, family and labor problems. Conclusions: Constructs about disease are founded on previous experiences about it, but not precisely on the healthcare professional´s knowledge. Therefore, it is necessary to prepare pregnant women for the emotional hardship behind suffering severe preeclampsia, assuming a nursery care differentiated, integral.