Women with a previous pregnancy complicated by preeclampsia have an increased risk for recurrence in subsequent pregnancies. For severe preeclamptic women in an initial pregnancy, recurrence rates for any type of preeclampsia are very high, approaching 50% in some studies. Significant maternal and fetal complications are more common in recurrent preeclampsia compared with an initial episode. For women who have experienced a pregnancy complicated by preeclampsia, a systematic evaluation for underlying risk factors may identify a specific pathway suitable for a specific intervention. Although some progress has been made in developing potential therapeutic options to prevent preeclampsia recurrence, there is a great need for better data to determine who will benefit most from any specific therapy.