Preeclampsia poses significant risks to maternal and fetal health, necessitating reliable methods for early prediction to facilitate timely intervention and mitigate adverse outcomes. This study investigates the predictive value of Pregnancy-Associated Plasma Protein-A (PAPP-A), Placental Growth Factor (PlGF), and uterine artery Doppler (UAD) in identifying preeclampsia risk. A Hospital-based Cross-sectional study was conducted among 90 antenatal cases attending to Obstetric clinic of MMC over a duration of twelve months. Receiver Operating Characteristic (ROC) curve analysis was employed to assess the diagnostic efficacy of PAPP-A, PlGF, and pulsating index (PI) in predicting preeclampsia. Among the biomarkers evaluated, PI exhibited the highest Area Under the Curve (AUC) value of 0.793, surpassing both PAPP-A (AUC = 0.272) and PlGF (AUC = 0.127). PAPP-A concentration below 0.5 MoM demonstrated a sensitivity of 50% and specificity of 82%, while a PlGF concentration below 0.75 MoM exhibited a sensitivity of 50% and specificity of 92% in predicting preeclampsia. Pl >2 had a sensitivity of 87.5% but a specificity of only 34%. In conclusion, lower levels of PAPP-A and PlGF, along with higher Pulsatility Index, are associated with an increased risk of pre-eclampsia.