Preeclampsia is a circulatory disorder, which is a pregnancy-specific syndrome characterized by newonset hypertension and proteinuria, occurring usually after 20 weeks of gestation. Although the etiology remains unknown, placental hypoperfusion and diffuse endothelial cell injury are considered to be the central pathologic events. The main focus is to review recent studies that link endothelial dysfunction and hypertension in preeclampsia, providing knowledge on placental factors that have profound effects on blood flow and arterial pressure regulation. Our review showed that preeclampsia possibly does not have a single cause but certainly involves multiple pathophysiological interactions. In conclusion, this review provides evidence on the role of the various factors and their interplay in the pathophysiology of preeclampsia. There is however, the need for further research to examine the influence of uteroplacental RAS in the pathogenesis of preeclampsia.