Introduction: Hypertensive disorder of pregnancy is one of the leading causes of maternal and perinatal mortality worldwide. Preeclampsia complicates 2–8% of pregnancies globally. Despite the serious clinical consequences, there is currently no effective preventive measure for preeclampsia; hence, the focus has shifted to identifying good predictors for diagnosing the severity of preeclampsia. Material and methods: This was a prospective cohort hospital-based study done in our Department of Obstetrics and Gynaecology, SN Medical College, Agra, Uttar Pradesh, India over a period of 12 months from January 2020 to January 2021. A total of 400 women were found to be eligible for the study after meeting inclusion criteria. All patients underwent detailed evaluation and investigation and the risk was calculated using the preeclampsia integrated estimate of risk (fullPIERS) calculator. All patients were followed weekly till delivery. Adverse maternal and fetal outcome were assessed. If the predicted probability of the adverse outcome came out to be ≥30%, then the case was considered as high risk. T-test and Chi-squared test were used for statistical analysis as appropriate. Results: Considering our cut-off value ≥30% in our study, out of 384 patients, 82 were categorized into high-risk group; among them, 54 (65.85%) patients had adverse maternal outcome (χ² = 96.413, p ≤ 0.0001). Among 377 patients, excluding seven women who expired in antenatal period, 75 patients (19.89%) were categorized into high-risk group (≥30% predicted probability), among them, 59 (78.67%) patients had adverse fetal outcome (χ² = 96.413, p ≤ 0.0001). Conclusion: The fullPIERS model successfully stratifies population into clinically relevant high-risk categories by using few important clinical and biochemical parameters and does not require extensive laboratory testing. It is economically feasible and quick to use, and predicts probability of an adverse outcome. Thus, the timely referral to higher center will help in having a significant impact in reducing the maternal morbidity and mortality; and perinatal morbidity and mortality associated with preeclampsia in low resource settings.