Objective: To find the association between testosterone serum levels and severity of late onset pre-eclampsia.Methods: This case-control study involved 34 patients with pre-eclampsia and 24 healthy control pregnant women matched for gestational and matal age. The recruited pregnant women were divided into two groups: the pre-eclampsia group (34 pregnant women with pre-eclampsia) and the control group (24 healthy pregnant women). Lipid profile, blood urea, serum creatinine, proteinuria, total serum testosterone, sex hormone binding globulin and free androgen index were evaluated. Moreover, body mass index and blood pressure profile were measured. Results: There were high systolic and diastolic blood pressures in the pregnant women with late-onset pre-eclampsia when compared with healthy pregnant women (P<0.01). Total serum testosterone was higher in women with pre-eclampsia compared with healthy pregnant women (P=0.001). The free androgen index was higher in women with pre-eclampsia compared with healthy pregnant women (P=0.001). Sex hormone binding globulin level was low in women with pre-eclampsia compared with healthy pregnant women (P=0.001). High total serum testosterone was significantly correlated with all measured variables (P=0.001), except for body mass index and pulse pressure (both P=0.070). Smoking habit was low in those patients compared with healthy pregnant women. Meanwhile, total serum testosterone serum level was significantly correlated with number of cesarean sections (r=0.86, P<0.01) and nulliparty (r=0.56, P<0.01). Conclusions: Late onset pre-eclampsia in pregnant women is associated with high serum levels of total serum testosterone, free androgen index, low sex hormone binding globulin, low smoking habit with positive history for nulliparity and caesarean sections that are correlated with high blood pressure profiles. Therefore, high total serum testosterone which is correlated with most of risk factors of late-onset pre-eclampsia is regarded as a proxy biomarker reflecting the severity of late onset pre-eclampsia.