Introduction: The hypertensive disorders in pregnancy (HDP) – gestosis score is a risk scoring system for developing preeclampsia (PE). It has a range of scores from 1 to 3. A pregnant woman is marked as “at risk for preeclampsia” if her overall score is 3 or higher. She is then managed accordingly. Aims: To predict PE, we assessed the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of the HDP–gestosis score. Materials and methods: A prospective research based on a hospital done for a duration of 1 year. Ninety-four pregnant women after 20 weeks of pregnancy were evaluated for the development of PE based on collected information on the patient's age, gravida, obstetric history, menstrual cycle regularity, polycystic ovarian disease history, length of the marriage, parity, prior medical and surgical intervention, prior/current medications, and family history. Gestosis score was determined and grouped into the following three risk categories: Mild (score of 1), moderate (score of 2), and high risk (score of 3 or more). Data were entered into Microsoft Excel 2007 and analyzed in statistical package for the social sciences (SPSS) software, version 2007 (IBM Corp., New York, USA). Results: The mean age, gestational age and body mass index (BMI) of the women were 24.34 ± 4.1 years, 13.7 ± 1.7 weeks, and 21.45 ± 1.9 kg/m², respectively. The gestosis score was 2 in 46.8% (n = 44) of the participants, 1 in 30.9% (n = 29), and ≥3 in 22.3% (n = 21) of the women. Preeclampsia developed in 23.4% (n = 22) of participants. The sensitivity, specificity, PPV, NPV, and diagnostic accuracy of HDP–gestosis score ≥3 for predicting PE were 86.36, 97.22, 90.84, 95.89, and 94.68%, respectively. Conclusion: Gestosis score is a useful clinical marker for PE development that enables patients to receive quick care, reducing the burden of developing PE.