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Background: Necrotizing enterocolitis (NEC) is an important cause of mortality and morbidity in preterm infants., Aims: To evaluate the effect of maternal preeclampsia on the development and severity of NEC in premature infants., Study Design: Prospective observational study in a tertiary neonatal intensive care unit., Subjects: The preterm infants of ≤ 37 gestational age who were consecutively hospitalized were enrolled. The study group contained preterm infants born to a preeclamptic mother and the comparison group contained preterm infants born to a normotensive mother., Outcome Measures: The primary outcome was to determine the association between preeclampsia and NEC., Results: A total of 88 infants had NEC diagnosis. The incidence of NEC in infants born to preeclamptic mothers (22.9%) was significantly higher compared with those born to normotensive mothers (14.6%). According to NEC stages, NEC was more advanced in preeclamptic mother infants. NEC developed significantly earlier in infants with NEC in the study group. The duration of NEC was also significantly longer in infants born to preeclamptic mothers. In multiple logistic regression model, preeclampsia was found to be predictive of NEC with an odds ratio of 1.74 (95% confidence interval 0.64-0.92)., Conclusions: Maternal preeclampsia may be an important risk factor for the development of NEC in premature infants as NEC incidence and severity of NEC were found to be significantly higher in premature infants born to preeclamptic mothers. The onset of NEC was significantly earlier and duration of NEC was longer in these infants., (Copyright © 2012 Elsevier Ltd. All rights reserved.)