Introduction: The goal of prenatal care is to improve maternal and fetal outcomes and identify and manage high-risk patients early. Antenatal surveillance, lifestyle change, nutritional supplements, and pharmaceutical therapy are current strategies for preventing pre-eclampsia, which is the precursor to eclampsia. Aim: To determine the prevalence of pre-eclampsia and eclampsia in unbooked pregnant women. Methodology: The study included 295 unbooked primigravida and multigravida women. Participants with any other confirmed medical conditions, such as persistent hypertension, diabetes, thyroid abnormalities, or known renal illness, were excluded from the study. Complete blood count, liver function tests, renal function tests, coagulation profile, and 24-hour urine for protein were all done on the study population. All of the patients were treated according to the department__ampersandsignrsquo;s standard procedure. Proteinuria was detected using a urine dipstick, a detailed urine report, or a 24-hour urinary protein test. Pre-eclampsia was identified with blood pressure monitoring. Study design: A cross-sectional study. Place and Duration: This study was conducted at Sohail Trust Hospital Karachi, Pakistan from November 2020 to November 2021. Results: The majority of the patients, 135 (45.76 %), were between 31 to 40 years of age. The average gestational age was 25.14__ampersandsignplusmn; 4.67 weeks. The average gravidity was 3.56 __ampersandsignplusmn; 5.65. The average parity was 2.34__ampersandsignplusmn; 0.67. The average height was 158.67 cm, with a margin of error of 15.67 cm. The average weight was 70.6__ampersandsignplusmn;6.65 kilograms. The average BMI was 30.76 kg/m2. Pre-eclampsia and eclampsia were found in 40 (13.55 %) and 25 (8.4 %) in unbooked pregnant women respectively. Conclusion: According to this study, pre-eclampsia and eclampsia are much more common in unbooked pregnant women. So, to improve the fetomaternal outcome, we recommend that national awareness programs be established in which pregnant women are encouraged and emphasized for early antenatal care, accurate dating, and early detection of maternal disorders that can threaten pregnancy and its outcome.