Objective: To verify the relationship between Urotensin II (UII) gene and serum levels and pre-eclampsia (PE). Study Design: Prospective case control study. Setting: Tertiary Obstetric centre and university hospital. Subjects: A total of 80 pregnant women at their third trimester were included, 30 of which were with mild PE, 30 with severe disease and 20 age- and BMI-matched normotensive pregnant women (controls). Materials and Methods: UII gene polymorphism as well as UII serum levels were assessed and compared in patients vs. control. Results: No difference was seen between the groups in terms of age or parity at the time of recruitment. A statistically significant difference in the Urotensin II genotype frequencies between patients and control groups was found. The mean serum UII, also showed a significant difference between the studied groups, and control group. Comparing the observed and expected values of UII genotype frequencies in mild, severe PE, and in controls, no significant difference was noted in the homo-mutant, the hetero-mutant or the wild genotypes. Conclusions: Elevation of UII in the serum of PE patients could be correlated to the severity and/or progression of the disease. The UII genotype frequencies between patients and control groups showed a significant difference, which implies a potential benefit for UII gene or level in serum as a diagnostic or prognostic indicator in pre-eclampsia.