Background <p>Pre-eclampsia, a hypertensive disorder of pregnancy remains a challenge worldwide despite advance in the medical science and research due to its adverse impact on pregnancy.</p> Objectives <p>To compare the clinical characteristics, sociodemographic risk factors and the pregnancy outcomes between proteinuric and non-proteinuric pre-eclampsia incorporating the revised definition.</p> Methodology <p>A prospective observational study consisting of 147 case of pre-eclampsia as per ISSHP-2018 diagnostic criteria of which 91 (63.6%) with proteinuria and 52 (36.4%) were without proteinuria. The maternal characteristics and pregnancy outcome were studied in both the groups and analyzed using appropriate statistical method.</p> Results <p>Use of revised definition lead to 1.5% increase in the incidence of pre-eclampsia (PE). A significantly higher proportion of non-proteinuric PE were ≤ 30 years as compared to proteinuric PE (78.8% vs. 61.5%, <i>p</i> value: 0.033). The proteinuric PE had significantly higher mean systolic and mean arterial pressure (<i>p</i> value: 0.011), higher association with clinically severe disease (<i>p</i> value: 0.008), higher values of serum creatinine (<i>p</i> value: 0.024) and serum LDH levels (<i>p</i> value: 0.004), higher rate of growth retarded fetus (<i>p</i> value: 0.029), low birth weight (<i>p</i> value: 0.014) and peri-natal mortality (<i>p</i> value: 0.018) as compared to non-proteinuric PE. However, the binary logistic regression analysis failed to demonstrate any significant difference between the two groups in any of the maternal characteristics or pregnancy outcome measures.</p> Conclusion <p>PE with or without proteinuria can be equally severe compromising the pregnancy outcome and hence demands for increase supervision and monitoring once diagnosis of PE is established.</p>