The purpose of the study was to evaluate the role of sFlt-1 / PLGF ratio (below or above the 95th percentile) in pregnancy complicated by early severe pre-eclampsia. The study included 34 patients with early severe pre-eclampsia in the second and third trimester of pregnancy (24-32 weeks). The concentrations of (sFlt-1 / PLGF) ratio were measured at the time of diagnosis of early severe pre-eclampsia with the use of The Elecsys immunoassays for sFlt-1 and PlGF (Roche Diagnostics). In this group of patients with early severe pre-eclampsia we observed that the higher levels of (sFlt-1 / PLGF) ratio (> p 95) (n=14) were associated with the shorter time of pregnancy lasting (3.04 weeks) and the lower neonatal weight (1421 gr). When compared to the group of patients with severe pre-eclampsia with a lower (sFlt-1 / PLGF) ratio < p95 (n=18) , time of pregnancy lasting (8.2 weeks) (p<0.001) and neonatal weight (2802 gr)(p<0.001) respectively. Pregnancy complicated by early severe pre-eclampsia and higher levels of (sFlt-1 / PLGF) ratio (above p > 95) were associated with worse perinatal outcomes – shorter time of pregnancy lasting and lower neonatal weight. These observations suggest the potential role of these markers in monitoring of pre-eclampsia. The determination of these angiogenic factors in clinical practice may be a good monitoring tool for detection of complications and help with decision making. A rise in sFlt-1 ratio / PLGF > p95 Is associated with a high risk of adverse perinatal outcome.