Preeclampsia is a very important cause of maternal and perinatal morbidity and mortality especially in low–income and middle–income countries including India. This study was aimed at determining the perinatal outcome of preeclampsia in a tertiary level hospital in North–East India. This cross–sectional analytical study was conducted at Regional Institute of Medical Sciences, Imphal from October 2016 to March 2018. Descriptive statistics like mean, standard deviation, percentage and inferential statistics like Chi–square test, Fisher’s exact test were used for analysing the data. Out of 96 preeclamptic women, 84 (87.5%) delivered live babies and 12 (12.5%) gave birth to intrauterine death (IUD) babies. Majority of the newborns (57.3%) were term followed by preterm (26.1%). Early preterm delivery was significantly associated with early neonatal death (p= <0.001). The mean birth weight of newborn was 2.43 ± 0.80 kg and the birth weight of less than 2.5kg was significantly associated with perinatal death (p= <0.001). There were 16.7% of newborns who had Apgar score of less than 7 at 5 minutes and required resuscitative measures and 19.8% of newborns got admitted mainly due to prematurity and birth asphyxia. There were 5 cases (5.2%) of early neonatal deaths and 17 (17.7%) cases of perinatal deaths. In the present study, the most common cause of early neonatal death was hyaline membrane disease (HMD) accounting for 40% of deaths. It was concluded that gestational age and birth weight of newborns were the main predictors of early neonatal death as well as perinatal death in preeclampsia.