OBJECTIVE To describe the profile and outcome of late-onset preeclampsia (LOPE). METHODS Retrospective study of 264 singleton pregnancies presenting before delivery at two referral centres in South Africa. RESULTS Primigravid patients constituted 56.8% of the group, while 57.6% were graded as severe. Median gestational age at diagnosis was 37 (34-43) weeks. 30.7% of patients experienced >or=1 major maternal complication including 34 (12.9%) cases of eclampsia. There were no maternal or early neonatal deaths. Five intrauterine deaths occurred, all due to placental abruption. The perinatal mortality rate was 18.9 per thousand births. CONCLUSIONS Late-onset preeclampsia often presents as severe disease.