Prenatal exposure to endocrine-disrupting chemicals (EDCs) has the potential to disrupt the placental barrier, resulting in abnormal fetal development that can lead to various obstetric complications including preeclampsia (PE). PE is a life-threatening hypertensive disease that mostly occurs during pregnancy, and its etiology is yet to be elucidated. Environmental exposures may also contribute to aberrant microRNA (miRNA) expression, DNA methylation, and histone modifications, which could serve as epigenetic signatures associated with the development of PE. Understanding the underlying molecular signaling pathways disturbed by environmental toxicants is critical for determining changes in exosomal cargo and release. Furthermore, this effect upsets homeostasis and contributes to disease progression at an early stage. Early PE is accompanied by expression of exomiRs, which modulate cell proliferation, migration, angiogenesis, inflammation, oxidative stress, endocrine dysregulation, and blood pressure. This review aimed to explore the impact of EDCs on various pathophysiological dysfunctions of PE and the potential role of exosomes in the early diagnosis of PE. Exosomes may be a valuable tool for diagnosing women at risk of developing PE, as they have been found to play a role in identifying abnormal pregnancies. This could create new opportunities for early detection and therapeutic intervention involving exosomes.