In clinical practice, we found despite the promise of some biomarkers in identifying women at increased risk for preeclampsia (PE) is still challenging! PE is a pregnancy-specific syndrome causes substantial maternal and fetal/neonatal morbidity and mortality worldwide. Despite decades of research, the etiology is incompletely understood and hence the ability of clinicians to predict PE prior to the onset of symptoms has not improved significantly. In this review, we will explore potential future areas of research underlying the pathophysiology of PE at the molecular level and potential biomarkers evolving for early prediction and diagnosis hoping to suggest novel therapeutic interventions.