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In this study, 23 women with established PE and 32 normal pregnant women were recruited.In human placenta, we detected an elevated C5a deposition in peeclamptic patients, which was colocalized with macrophages.C5a receptor (C5aR) was found highly expressed in syncytiotrophoblasts.In cultured trophoblast cell lines (HTR8/SVneo and JAR), we showed that C5aR agonist peptide inhibited the migration and angiogenesis of trophoblasts.C5aR agonist peptide stimulation also resulted in increased anti-angiogenic factors gene level as IL6, IL1β, MCP1 and sFIt1, but decreased pro-angiogenic facors gene level as IL-10 and HIFα in the trophoblast cells.In maternal circulation, the level of C5a was elevated in women with PE.Arterial stiffness measurement was also carried out to evaluate maternal vascular function, as a result, women with PE underwent poor arterial function, which was positively correlated with C5a level.Additionally, we observed reduced percentage of M2 and increased percentage of M1 monocytes in preeclamptic women, associated with an increased level of C5a.