Background Pre-eclampsia and eclampsia are parts of the broader spectrum of hypertensive disorders complicating pregnancy. This study aims to examine the association between serum inhibin and leptin levels and pre-eclampsia. Methods This study included 98 consecutive cases of pregnant women with pre-eclampsia, together with their 98 pregnant controls, matched for age, gestational week and time period of delivery. Maternal venous blood samples were obtained within 24 h before delivery. In addition to serum inhibin and leptin, birth order, multiple pregnancy, maternal age, maternal overweight/obesity, maternal education, maternal smoking and family history of diabetes/hypertension, were examined as risk factors. Multivariate logistic regression analysis was performed. Results At the univariate analysis, serum inhibin and leptin levels were significantly higher in cases vs. controls. Pre-eclampsia occurred more frequently in primiparous women, whereas overweight and obesity were also associated with pre-eclampsia. At the multivariate analysis, higher serum inhibin levels were associated with pre-eclampsia (multivariate OR = 1.09, 95%CI: 1.03–1.17, p = 0.004, increase per 0.1 ng/mL). On the other hand, leptin was not independently associated with the occurrence of pre-eclampsia (multivariate OR = 1.02, 95%CI: 0.95–1.09, p = 0.631, increase per 10 ng/mL). Conclusions Elevated serum inhibin levels seem to be associated with pre-eclampsia, reflecting placental dysfunction. Increased serum leptin levels may merely reflect an elevated maternal body mass index, which is a well-known risk factor for pre-eclampsia. [ABSTRACT FROM AUTHOR]