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Pre-eclampsia (PE) is a multisystem disorder of unknown cause, is unique to human pregnancy. Over the last two decades many biochemical factors have been selected to detect their predictive value in PE. More recent studies have claimed that increased urinary levels of collagen IV can predict early diabetic nephropathy. This study was done to explore whether elevated urinary concentration of collagen IV in early pregnancy is potentially a more sensitive predictor of PE than microalbumin (MA). Among 119 study subjects, the sensitivity of ACR for PE was 80%, specificity 49.54%, PPV 12.69% and NPV 96.42%. In case of collagen IV, the sensitivity was found to be 70%, specificity 52.5%, PPV 11.5% and NPV 94.8%. Since detection of urinary collagen IV is a relatively costly test compared to MA rather it does not give any added advantage, its use may not be advocated to predict PE in cases of pregnancy. This study took place in developing nations like Bangladesh, where maternal and fetal deaths from preeclampsia are greatest and tertiary care facilities are limited. Prediction of PE might allow a reduction of the worldwide mortality and morbidity.