Objective — to analyze the current clinical features of the most severe forms of preeclampia and eclampsia and to assess diagnostic and treatment management tactics for patients who have died from preeclampsia, eclampsia, and their complications in Russia in 2014. Material and methods. The copies of primary medical records relating to 25 maternal deaths from preeclampsia and eclampsia in the Russian Federation in 2014 were retrospectively analyzed. Results. The current clinical features of the most severe forms of preeclampsia and eclampsia were presented. The most common errors of outpatient and inpatient medical care were identified. Conclusion. Practical healthcare has no methodical tools to predict severe early-onset preeclampsia. It is necessary to introduce modern scientific advances into the practical activity of obstetricians/gynecologists, which are concerned with the estimation of the risk of early-onset preeclampsia for use just at the end of the first trimester of pregnancy. The authors declare no conflicts of interest.