Background: Preeclampsia and eclampsia are critical complications of pregnancy that significantly impact maternal and neonatal health. These conditions are associated with adverse outcomes, particularly in preterm deliveries. Understanding predictors of neonatal outcomes is essential for improving care and reducing risks. Objective: This study aims to identify predictors of neonatal outcomes in women with preeclampsia or eclampsia between 26 and 36 weeks of gestation, with a focus on maternal, clinical, and biochemical factors, while highlighting the collaborative role of the Departments of Pediatrics and Obstetrics & Gynecology. Methods: A cross-sectional study was conducted at departments of Pediatrics and Gynecology/Obstetrics, Hayatabad Medical Complex Peshawar, from January 2023 to January 2024, involving 95 women with preeclampsia or eclampsia. Data collection was carried out in collaboration between the Departments of Obstetrics & Gynecology and the Department of Pediatrics. Maternal demographics, clinical variables, and biochemical markers were recorded by obstetricians, while neonatal outcomes, including gestational age at delivery, birth weight, Apgar scores, and neonatal complications, were meticulously documented by pediatricians. Statistical analysis was performed using SPSS software to identify factors influencing neonatal outcomes. Results: The majority of women (65.3%) were aged 20–35 years, and 61.1% were primiparous. Severe preeclampsia was observed in 56.8% of cases, and 72.6% received magnesium sulfate. Neonates born before 30 weeks accounted for 26.3%, with a significant association between preterm birth and low birth weight, poor Apgar scores, and increased neonatal complications. Elevated maternal uric acid and abnormal Doppler findings were significant predictors of adverse neonatal outcomes. Neonatal mortality was 9.5%, primarily among those born before 30 weeks. Conclusion: Preeclampsia and eclampsia significantly affect neonatal outcomes, particularly in preterm deliveries. Early detection and interventions, such as magnesium sulfate and corticosteroids, are crucial for improving neonatal health. Effective collaboration between Obstetrics & Gynecology and Pediatrics departments plays a vital role in optimizing maternal and neonatal care outcomes.