Objectives: To determine the predictive values of low urinary calcium/creatinine ratio and microalbuminuria for preeclampsia in a spot urine sample in asymptomatic pregnant women between 20 weeks and 32 weeks of gestation. Materials and methods: One hundred fifty pregnant women who attended the obstetrics and gynecology (OBG) OPD, JSS Hospital, Mysuru for routine antenatal care between 20 weeks and 32 weeks of gestation were included in the study and was followed up till term for clinical pieces of evidence of preeclampsia. Results: The incidence of preeclampsia was high among primigravidas (69.3%) compared to multigravidas (30.7%). Total 16 out of 150 pregnant women developed preeclampsia. Out of 16, 13 developed preeclampsia among cases and 3 in controls. The value of urinary calcium/creatinine ratio (UCCR) < 0.04 is taken as cut off value. 14 out of 16 patients have low urinary calcium/creatinine ratio out of which 11 (68.8%) patients developed preeclampsia subsequently. In the study group 11 (84.6%) patients, with urinary calcium/creatinine ratio < 0.04 developed preeclampsia and 2 (15.4%) patients with urinary calcium/ creatinine ratio > 0.04 developed preeclampsia. In the control group, one patient with significant urinary calcium/creatinine ratio did not develop preeclampsia. Conclusion: The study shows that urinary calcium/creatinine ratio < 0.04 is an excellent screening tool for the prediction of preeclampsia with a specificity of 97%, sensitivity 68%, positive predictive value 78%, and negative predictive value 96% and microalbuminuria as a fair predictor of preeclampsia