Pregnant women with chronic diseases are at a high risk of developing adverse outcomes, including superimposed preeclampsia. Prediction and diagnoses of superimposed preeclampsia in women with high-risk pregnancies is often challenging. Pro-angiogenic factors: placental growth factor (PlGF), as well as the anti-angiogenic factors: soluble Fms-like tyrosine kinase-1 (sFlt-1) and soluble endoglin (sEng) have gained increasing attention for their role in the pathogenesis of preeclampsia. Changes in serum concentrations of pro and anti-angiogenic factors are associated with the occurrence of superimposed preeclampsia in high-risk pregnancies. These changes are present up to four weeks before the final clinical manifestations of the disease. Pro and antiangiogenic factors might be useful for risk stratification of superimposed preeclampsia and other adverse outcomes in high-risk pregnancies. The aim of opinion is to describe the clinical usefulness of serum concentrations of pro and anti-angiogenic factors as biomarkers in progression and diagnoses to superimposed preeclampsia in women with high-risk pregnancies.