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Pre-eclampsia is a serious hypertensive disorder of pregnancy that affects 3% - 5% of pregnancies, and remains the leading cause of maternal and neonatal mortalities and morbidities in the world. It is a multisystemic disease with the common features of hypertension and proteinuria. In serious cases, termination of pregnancy is the only available option to prevent further deterioration of the fetus and mother. To date, the factors triggering, and the underlying mechanisms, responsible for the pathogenesis of pre-eclampsia remain unknown. Recently, numerous studies have shown that pre-eclamptic women possess autoantibody against angiotensin Ⅱ type 1 receptor, which bind to and activate the receptor provoking biological responses relevant to the pathogenesis of pre-eclampsia. The current paper is to review the most recent development.