(BJOG. 2020;127:478–488)Preeclampsia is associated with maternal and perinatal morbidity, causing 1 in 5 maternal deaths in low-resource countries. While low-dose aspirin has been moderately effective in treating preeclampsia, there is a clear need for a more effective treatment. Elevated circulating levels of soluble fms-like tyrosine kinase-1 (sFlt-1) have been observed in women with preeclampsia. Statins reduce sFlt-1 from cultured cells, and in pregnant animals with a preeclampsia-like syndrome, statins have improved outcomes. This study aimed to investigate the effects of pravastatin 40 mg daily on the clinical condition and maternal plasma sFlt-1 levels in women with early-onset preeclampsia.