Objective-To find whether placental laterality as determined by ultrasound can be used as a predictor of the development of preeclampsia and to find its correlation with severity of preeclampsia, maternal and fetal outcomes. Design- Prospective study Setting-LLRM Medical college, Meerut, Antenatal clinic from October 2022 to March 2024 Sample- A total of 344 low-risk singleton pregnant women. Methods:. At 18–24 weeks, an ultrasound was used to locate the placenta in the above mentioned women. Two groups of women were created: group A had a central placenta, while group B had a lateral placenta. The study’s end point was the onset of preeclampsia according to the RCOG criteria. Outcome-To analyse placental localisation as a predictor of preeclampsia development and its association with feto-maternal outcomes. Results: Of the 344 pregnant women, 210 (Group-A) had a central placenta, and 134 (Group-B) had a lateral placenta. Out of total women, 69.2% with lateral placenta and 30.8% with central placenta developed preeclampsia. This difference is found to be highly significant statistically (p value <0.01). As a screening test, placental laterality has the following sensitivity, specificity: 69.23%, 66.44% respectively. Conclusions: The placental laterality as assessed by ultrasonography at 18–24 weeks is a simple, reliable and cost effective predictive screening tool for the onset of preeclampsia.