Objective: To evaluate early-pregnancy changes in lipid profile in recurrent preeclampsia. Methods: In this retrospective observational study, blood samples were obtained from 41 normotensive women with a history of early-onset preeclampsia preconceptionally and at 12 and 16 weeks in the next pregnancy. We assessed triglycerides (TGs), total cholesterol (TC), and high-and low-density lipoprotein cholesterol (HDL-C and LDL-C, respectively). We analyzed differences in longitudinal patterns between normal and recurrent preeclamptic next pregnancy using mixed-design repeated measurements analysis of covariance (ANCOVA). Results: Eleven (28%) women developed recurrent preeclampsia. Eighteen (45%) women had a normal pregnancy. In normal pregnancy, LDL-C declines transiently in the first trimester (P <.01). In women who develop recurrent preeclampsia later on this decline was absent. Moreover, from 12 weeks onward the elevating levels of HDL-C stagnates in women who subsequently develop recurrent preeclampsia (P = .02). Conclusion: These observations point to an abnormal early adaptation of lipid metabolism to pregnancy preceding clinical manifestation of preeclampsia.