Pre-eclampsia/Eclampsia has significant impact on maternal and perinatal health. Little is known about prevalence and risk factors for pre-eclampsia/eclampsia in Tanzania. This study aimed to determine prevalence and risk factors for pre-eclampsia/eclampsia among women who delivered at KCMC  hospital between 2000 and 2014. Retrospective cross-sectional study was conducted at KCMC medical birth registry. Multivariable logistic regression models were performed to obtain odds ratios with 95% CI for factors associated with pre/eclampsia. P-value<0.05 was considered statistically significant. A total of 40,176 mothers were analysed. The prevalence of pre/eclampsia was 4.2%. Factors  such as maternal age (≥35) years (AOR = 1.73), ≥12 years of schooling (AOR=1.29), being unmarried (AOR=2.03), overweight (AOR=1.99), obesity (AOR=5.52),  hypertension (AOR=18.66), anaemia (AOR=3.53), and multiple pregnancy (AOR=6.58),  were  associated with higher risk of pre-eclampsia/eclampsia  while ANC visits (≥4) reduced the risk of pre-eclampsia (AOR= 0.78). This study provides an estimate of prevalence of pre-eclampsia at KCMC hospital in Northern Tanzania. Factors such as advanced maternal age (≥35 years), ≥12 years of schooling, being unmarried, overweight, obesity, hypertension, anaemia and multiple pregnancy were associated with higher risk of pre-eclampsia while having ≥4 ANC visits reduced the risk of pre-eclampsia at KCMC.