Objective: To determine the efficacy of point urinary albumin to creatinine ratio at 20+0 and 28+0 weeks of gestation for predicting the possibility of developing pre-eclampsia, late in pregnancy. Material and methods: This cross-sectional study was conducted at DHQ Hospital Narowal from July 2019 to December 2019 over the period of 6 months. Total 200 patients were selected. Patients were divided on the basis of development of pre-eclampsia and their mean Albumin to creatinine ratio was compared by applying Student’s t-test considering p≤0.05 statistically significant. Results: Mean urinary albumin to creatinine ratio was 22.77±12.42 mg/mmol in normotensive women and 46.87±15.13 mg/mmol in pre-eclamptic women which was significantly higher in pre-eclamptic patients (p<0.001). The sensitivity of point urinary albumin to creatinine ratio at a cutoff value of 35.5mg/mmol is 73.91%; the specificity is 91.56%; the positive predictive value (PPV) is 72.34%; and negative predictive is 92.16%. Conclusion: Our study concluded that solitary point urinary albumin creatinine ratio values equal to or higher than 35.5mg/mmol, when quantified early during the second trimester had a higher specificity than the sensitivity and it can be safely used to rule out the possibility of developing pre-eclampsia, late in pregnancy. Keywords: Albumin to Creatinine Ratio, Pre-eclampsia, Normotensive, Point Urinary.