Background: Preeclampsia (PE) remains a leading cause of maternal and perinatal morbidity and mortality, mainly due to complication, especially in resource-limited settings. This study aimed to identify maternal factors associated with PE complications, to help identify ways to orient limited resources. Methods: We conducted a case-control study at three tertiary hospitals in Yaoundé: the Yaoundé Gynaeco-Obstetric and Paediatric Hospital, University Teaching Hospital, and Central Hospital. Records of women admitted for preeclampsia between January 2022 and December 2023 were reviewed. Cases were women with maternal complications of preeclampsia, while controls were those with preeclampsia and no complications, matched by maternal age. Data were analysed using R version 4.3.3. Pearson’s chi-squared test and Student’s t-test were used for comparisons, and adjusted odds ratios (aORs) determined using multiple logistic regression. Results: We recruited 291 participants (97 cases and 194 controls). The most frequent complications were eclampsia (59.2%) and HELLP syndrome (18.5%). Risk factors were alcohol consumption during pregnancy (aOR = 2.53; 95% CI: 1.19–5.40; p=0.016) and having a new partner (aOR = 3.63; 95% CI: 1.14–11.57; p=0.029). Age >20 years (aOR = 0.87; 95% CI: 0.80–0.94; p<0.001), and having ≥ 5 ANCs (aOR = 0.71; 95% CI: 0.58–0.88; p=0.001), were protective. Conclusion: Eclampsia was the most common complication of PE at these hospitals. Factors associated with complications were alcohol consumption, a new partner, and suboptimal ANC. We emphasize the importance of optimum antenatal care, and avoidance of alcohol, to promote prevention and early case detection and management.