Aim: The aims of the present study were to assess the correlation between homocysteine and adiponectin and the homocysteine-to-adiponectin ratio in pre-eclampsia compared with normal pregnant women.Materials And Methods: The study population consisted of 30 women with pre-eclampsia and 30 normal pregnant women. Serum levels of total adiponectin and total homocysteine were assessed using commercially available enzyme-linked immunosorbent assay methods. Data are presented as median.Results: Serum levels of total adiponectin correlated directly with total homocysteine in both pre-eclampsia (r = 0.48, P = 0.01) and normal pregnancy (r = 0.68, P = 0.001). The homocysteine-to-adiponectin ratio was increased significantly in pre-eclampsia compared with normal pregnancy (0.90 vs 0.70, P = 0.03). Compared with normal pregnancy, women with severe pre-eclampsia showed significant increase in total adiponectin (14.29 vs 10.24, P = 0.01), total homocysteine (13.80 vs 7.25, P = 0.000) and homocysteine-to-adiponectin ratio (0.92 vs 0.70, P = 0.02). Women with mild pre-eclampsia had higher values of total adiponectin (16.19 vs 10.24, P = 0.000) and total homocysteine (13.11 vs 7.25, P = 0.000) compared with normal pregnancy. No significant differences were observed between mild and severe pre-eclampsia.Conclusion: The present study showed a positive association between adiponectin and homocysteine in pre-eclampsia. The homocysteine-to-adiponectin ratio may be an informative biomarker for the disease diagnosis and therapeutic monitoring.