After 20 weeks of pregnancy, proteinuria and new-onset hypertension are hallmarks of preeclampsia, a complex hypertensive pregnancy disease that frequently coexists with systemic organ failure. It continues to be a major cause of maternal and newborn morbidity and mortality, affecting 5–8% of pregnancies worldwide, especially in environments with low resources. Although it has historically been associated with placental malfunction, mounting data indicates a substantial neurovascular involvement, including disruption of the blood-brain barrier (BBB), neuroinflammation, and oxidative stress, which results in cerebral edema, ischemia, and bleeding. Headaches, seizures, visual abnormalities, and posterior reversible encephalopathy syndrome (PRES) are examples of neurological symptoms. The characteristics of preeclampsia, a complicated hypertensive pregnancy syndrome that often coexists with systemic organ failure, are proteinuria and new-onset hypertension after 20 weeks of pregnancy. It still accounts for 5–8% of pregnancies globally, particularly in low-resource settings, and is a leading cause of maternal and neonatal morbidity and mortality. Growing evidence suggests a significant neurovascular involvement, including disruption of the BBB, neuroinflammation, and oxidative stress, which leads to cerebral edema, ischemia, and bleeding, despite its historical association with placental dysfunction. Neurological symptoms include visual problems, headaches, seizures, and PRES. Long-term monitoring, supportive care, and neuroprotective techniques are crucial, especially for cardiovascular risks and postpartum problems. The burden of preeclampsia can be lessened by addressing health inequities and including preventive care. Its neurovascular and systemic interactions warrant more investigation in order to develop novel therapeutic strategies that will eventually enhance the results for mothers and newborns.