Introduction. Preeclampsia is a pregnancy complication affecting both the mother and the fetus. Although there is no proven effective method of preventing preeclampsia, however, early detection of the risk of preeclampsia and subsequent monitoring, pharmacological and non-pharmacological treatment of the risk group can reduce the likelihood of developing preeclampsia and improve its outcomes. Very little is known about the cost-effectiveness of early detection of preeclampsia risk groups tests, mainly because there is no clear treatment and prevention plan. The purpose of this study is to conduct a comprehensive review of existing data on the cost-effectiveness of screening to identify risk groups and prevent preeclampsia and to conduct our own clinical and economic analysis of the effectiveness of the recently actual measures taken. Material and methods. Modern trials examining the clinical and cost-effectiveness efficiency of preeclampsia prevention and its outcomes have been studied. The systematic review was conducted according to the PRISMA guidelines and using certain PICO(S) criteria. Our own clinical and economic research was conducted using the determination of the cost of the disease burden, the construction of the Markov model and the use of the cost–effectiveness method. Results. An analysis of the conducted clinical and economic studies of the identification of preeclampsia risk groups and preventive effects on them has shown the effectiveness of this approach. Our own data obtained as a result of a cost-effectiveness study confirm this: identifying preeclampsia risk groups and carrying out preventive measures in it can reduce the incidence of PE by 2.5 times (or by 9,000 cases per year), save 17 maternal lives and 1,175 children's lives per year and spare about 270 billion rubles for the state. Discussion. The other analyzed metanalysis and own conducted trial approve that the prophylaxis of preeclampsia is cost-effective. Conclusion. The existing methodology in Russia for identifying the risk group for developing preeclampsia based on anamnesis, blood pressure measurement, uterine artery ultrasonographic examination, and results of placental growth factor analysis allows saving more than 1,000 lives annually and is economically justified.