Background: Evidence suggests the involvement of calcium and magnesium metabolism in the pathophysiology of preeclampsia. However, findings from studies are heterogenous and inconsistent. Aim: The study aimed to compare the total serum calcium and magnesium levels in preeclamptic women with that of normotensive pregnant women. Subjects and Methods: A crossâsectional subjects of eighty pregnant women living in Abakaliki, Ebonyi state, SouthâEast Nigeria, were recruited into the study. The present study compared serum calcium and magnesium in forty preeclamptic (cases) and forty normotensive (control) pregnant women matched for age, parity, and socioeconomic status. Serum calcium and magnesium levels were measured using atomic absorption spectrophotometer. Statistical analysis was done using SPSS Version 20 statistical software. Differences between means were compared using Student’s tâtest with P < 0.05 considered as statistically significant. Results: While the mean serum calcium was comparable between preeclamptic and normotensive pregnant women (13.99 [3.29] vs. 14.02 [5.68] μg/dl), the preeclamptic pregnant women have significantly (P < 0.001) lower serum magnesium in comparison to their normotensive counterparts (3.22 [1.05] vs. 4.15 [0.78]). Conclusion: It may be concluded that serum magnesium seems to play a crucial role in the pathophysiology of preeclampsia in this environment.