The study investigated the predictive value of serum uric acid (UA) and lactate dehydrogenase (LDH) for severe maternal morbidity in preeclampsia in a retrospective analysis of age-matched cases and healthy controls at a tertiary care center. Mean UA was higher in the preeclampsia group (5.8 ± 1.3 mg/dl vs 4.4 ± 1.1 mg/dl, p < 0.001), as were mean LDH (410.7 ± 194.0 vs 267.2 IU/l, p < 0.001) and BMI (29.5 ± 4.2 vs 26.1 ± 3.8 kg/m², p < 0.001). 0.001). UA independently predicted acute kidney injury (aOR 3.21, 95% CI 2.50–4.12) at 6.3 mg/dL with an AUC of 0.924 and a 97.8% negative predictive value (NPV). UA ≥ 8.0 mg/dL had 100% sensitivity for neurological seizures and UA ≥ 6.1 mg/dL 90.9% sensitivity for visual loss. A mean LDH ≥ 516.4 IU/L showed a 99.4% NPV to rule out pulmonary edema. However, LDH did not lose its independent predictive significance for most morbidities after adjustment in the multivariable model. There were no deaths related to preeclampsia and the study recommends prospective multicenter validation.