Objective: First-trimester uterine artery Doppler was declared as a useful tool for predicting preeclampsia. Placental volume and vascular indices were recently used to predict preeclampsia. The study aims to assess the role of the first-trimester 3D placental volume and power Doppler of placental vascular indices combined with the uterine artery Doppler indices in prediction of preeclampsia. Design: A prospective cohort study Sample: 2019 women with a singleton pregnancy in their first-trimester. Methods: At 11-13+ weeks of gestation, 3D trans-abdominal ultrasound with Doppler scan for all participants then they were followed up until delivery. Main Outcome Measures: 3D placental volume, 3D Power Doppler of placental blood flow and uterine artery Doppler in the first trimester. Results: 163 women developed preeclampsia while 1856 women were normotensive. In the preeclampsia group, the placental volume, placental vascular indices (VI, FI, and VFI) showed a significant decrease, while means uterine PI and RI showed a significant increase. The placental vascular indices (VI, FI, and VFI) showed higher sensitivity while the placental volume and the uterine artery Doppler indices (PI and RI) showed higher specificity for the prediction of preeclampsia. Conclusion: Combined early screening of uterine artery Doppler with placental volume and vascular indices could be beneficial to increase the accuracy of early prediction of preeclampsia. Funding: There is no specific grant from any funding agency. Keywords: 3D-Doppler ultrasonography; placental volume; placental vascular indices; uterine artery Doppler; preeclampsia