The present study was designed to determine the association between PZ promotor A13G polymorphism, PZ levels, anti-PZ antibodies levels, and the occurrence of preeclampsia (PE). A case-control study including normal pregnant women (control group, n=75) and pregnant women with PE (PE group, n=125) was performed. PZ levels (mg/L) were significantly lower in PE group (1.45 ± 0.21) than control group (2.07 ± 0.29, p < 0.05). The plasma anti-PZ IgG concentrations (AU/ml) in PE group (5.2 ± 0.62) were significantly higher than that in control group (3.3 ± 0.61, p < 0.05), while there were no significant differences of anti-PZ IgM concentrations (AU/ml) between two groups (12.2 ± 0.92 vs. 12.2 ± 1.18, p > 0.05). Multivariate analysis showed that decreased PZ [OR (95% CI) = 200.39 (11.80-3403.91)] and elevated anti-PZ IgG [OR (95% CI) = 0.013 (0.002-0.088)] were independent risk factors of PE. The results suggested that low PZ levels and high anti-PZ IgG levels are associated with the occurrence of PE.