Objetivo: Identificar los principales factores de riesgo que en nuestro medio se asocian a la presentacion de la preeclampsia en sus formas severa y temprana. Metodologia: Se realizo un estudio de casos y controles de preeclampsia severa y lejana del termino. Lugar: Mujeres que tuvieron su parto en el Hospital General de Medellin (HGM) entre septiembre de 1999 y marzo de 2000. Participantes: Se tomaron 126 pacientes que tuvieron diagnostico de preeclampsia severa o temprana (antes de las 30 semanas de gestacion), y los controles fueron 136 mujeres que no presentaron ninguna complicacion hipertensiva durante su embarazo. Proposito: Direccionar los esfuerzos investigativos hacia el estudio de los factores de riesgo para la preeclampsia severa y temprana, buscando en lo posible modificarlos, estableciendo un perfil de riesgo que nos oriente en la toma de decisiones mas confiables y tempranas. Resultados: Se encontro que los factores de riesgo con mas significancia estadistica fueron el antecedente personal de hipertension durante la gestacion (O.R:2.89, IC 95%: 1.28-6.62), el antecedente familiar de hipertension durante la gestacion (O.R: 2.70, IC 95%: 1.26-4.82), y el de hipertension cronica (O.R: 2.76, IC95%: 1.59-4.82). Conclusion: Los factores de riesgo que mas se asociaron son factores relacionados con la historia personal y familiar del individuo, que no son susceptibles de modificacion o de intervencion con la tecnologia actual, pero que si le permiten al clinico un diagnostico mas temprano y oportuno del sindrome, ademas de darle elementos para direccionar la atencion de estas embarazadas hacia centros de salud de mayor complejidad. Llama la atencion que aquellos factores relacionados con la primipaternidad y con los habitos sexuales no presentaron ninguna diferencia estadisticamente significativa entre grupos, orientandonos quizas hacia etiologias principalmente de origen gen etico o hereditario. ABSTRACT Objective: To identify the main risk factors associated with Preeclampsia in their forms severe and early. Design: A case - control study for early and severe preeclampsia. Setting: Women who had their childbirth in the General Hospital of Medellin (HGM) between September of 1,999 September and March of 2.000. Participants: Preeclampsia cases (n= 126) were determined from discharge diagnosis of severe and early preeclampsia disease (before the 30 weeks of gestation). and controls (n = 136) were women without diagnosis of any hypertensive disorder during their pregnancy. Purpose: to guide the research efforts towards the study of the risk factors for severe and early Preeclampsia, looking for those that are possible to modify, establishing a risk profile that orients in a more reliable and early decision making. Result: We found that the risk factors more statistically associated were: personal history of arterial hypertension during the pregnancy (OR: 2.89, CI95%: 1.28 - 6.62), familiar history of preeclampsia (OR: 2,70 CI95%: 1.26 - 4,82). And familiar history of the chronic hypertension (OR: 2.76, IC95%: 1.59~ 4.82). Conclusions: The risk factors more associated to severe and early preeclampsia were personal and familial history. With the current technology these factors are very difficult to become modified, but with a earlier and more opportune diagnosis of the syndrome, besides to give elements to guide the attention of these pregnant women towards to more complexity health centers. The factors related to the first paternity and the sexual habits had not statistically significant difference between groups, orienting to us, perhaps towards aetiologies mainly of genetic or hereditary origin.