Purpose: This study evaluated serum amino-terminal pro-B-type natriuretic peptide (NT-proBNP) levels and echocardiography to determine their efficacy as markers for predicting postpartum pulmonary edema in patients with severe preeclampsia. Methods: We evaluated the NT-proBNP levels and echocardiographic results of 124 preeclamptic women (gestation preeclampsia (GPE) group, n = 77; superimposed preeclampsia on underlying hypertension (SPE) group n = 47). Patients were also divided into postpartum pulmonary edema (PPE, n = 28) and non-pulmonary edema (NPE, n = 96) groups. NT-proBNP levels and echocardiographic parameters were compared between groups, and their correlations were also evaluated. Statistical analysis was carried out using variance analysis, and significance was set at p < 0.05. Results: The SPE group had significantly higher NT-proBNP levels than the GPE group. They were also more likely to have PPE, but this was not significant. Echocardiography showed no significant differences in the left ventricular (LV) ejection fraction (LVEF) of the two groups, but a mild LV diastolic dysfunction was noted in the SPE group. The PPE group had significantly higher serum NT-proBNP levels and lower LVEF than the NPE group. There were no significant differences in the echocardiographic parameters of diastolic cardiac dysfunction in the two groups. The serum NT-proBNP levels were significantly negatively correlated with LVEF. Conclusions: PPE in patients with severe preeclampsia was associated with impaired cardiac function, especially LV systolic dysfunction. Serum NT-proBNP levels and echocardiography may be useful predictive markers for postpartum pulmonary edema in women with severe preeclampsia.