Background: Preeclampsia is a leading cause of maternal mortality worldwide and a serious health problem that affects the majority of women. Aim: We investigated the association between lipid profile and maternal obesity among preeclamptic women in the Cape Coast Metropolis. Subject and Methods: This case–control study involved 60 preeclamptics and 50 healthy pregnant controls matched for age and gestational weeks consecutively recruited from two major hospitals in the Cape Coast Metropolis. Blood samples were collected after overnight fasting and enzymatic spectrophotometric tests used to estimate lipid concentrations. The independent samples t‑test, Chi‑square, and Pearson’s correlation were used in the analysis of data gathered. Results: Serum triglyceride (TG) (P = 0.04), very low density lipoprotein (VLDL) (P = 0.02), TC (P = 0.01) and low density lipoprotein (LDL) (P = 0.03) levels were higher in preeclamptic participants than in the controls. High density lipoprotein concentration showed no significant variation between the two groups (P = 0.83). Preeclamptic women were more obese (P = 0.07). High body mass index (OR = 1.501; CI = 0.926‑2.106, P = 0.01), high TG level (OR = 5.026; CI = 0.794‑31.818, P = 0.01), were associated with preeclampsia. Conclusion: Lipid abnormalities, mostly elevated levels of TG, TC, LDL, and VLDL are present in preeclamptics. High TG levels and maternal obesity are associated with preeclampsia among pregnant women in the Cape Coast Metropolis.