Pre-eclampsia (PE) is found in 2-8% of pregnancies and is one of the leading causes of mortality and morbidity. Several studies showed an increased cardiovascular risk of PE in the form of hypertension, heart failure, ischemic heart disease, venous thromboembolism and death. This study aims to evaluate all available evidence on the effect that PE with severe features has on long-term cardiovascular risk compared with PE without severe features. PubMed and ProQuest were searched from January 2000 to December 2019 to identify relevant articles. We estimated the risk by using random effect meta-analysis. Twelve studies involving more than three million women were included. Our study showed the pooled relative risks (RRs) for women with a history of severe PE compared with mild PE were 1.32 (95 % confidence interval [CI] 1.13-1.53) for hypertension, 1.74 (95% CI 0.81-3.72) for heart failure, 1.06 (95% CI 0.78-1.43) for ischemic heart disease, 1.20 (95% CI 0.93-1.54) for thromboembolism, 1.46 (95 % CI 0.92-2.32) for cardiovascular hospitalization, and 1.02 (95 % CI 0.73-1.43) for cardiovascular mortality. Other study on ventricular fibrillation could not be pooled. Severe preeclampsia has an increased risk of hypertension by one- to two-fold compared to mild preeclampsia. Women with a history of preeclampsia should be educated about lifestyle modification as well as regular monitoring to reduce the risk of cardiovascular disease. Further consideration and evaluation should be given to preeclampsia with severe features.