Preeclampsia remains a major contributor to maternal and perinatal morbidity and mortality, particularly in low- and middle-income countries where early detection at the primary healthcare level is often limited. This study aimed to analyze the relationship between maternal risk factors and the incidence of preeclampsia among third-trimester pregnant women at Tilamuta Primary Health Center. An analytical observational study with a cross-sectional design was conducted in 2025 involving 45 pregnant women selected using total sampling. Data were collected from antenatal care registers and maternal medical records. The independent variables included maternal age, gravidity, educational level, history of hypertension, and history of diabetes mellitus, while the dependent variable was the incidence of preeclampsia. Data analysis was performed using chi-square tests and logistic regression with a significance level of 0.05. The prevalence of preeclampsia in this study was 42.2%, indicating a high burden of hypertensive disorders during pregnancy. Maternal age and educational level were significantly associated with preeclampsia (p < 0.05). A history of hypertension showed a significant association with preeclampsia and remained the strongest independent predictor in multivariate analysis. In contrast, gravidity and history of diabetes mellitus were not significantly associated with preeclampsia. These findings highlight the importance of strengthening antenatal screening, particularly for women with pre-existing hypertension, to support early detection and prevention of preeclampsia at the primary healthcare level