Background: Preeclampsia is a life threatening state.  Aerobic exercise has a beneficial effect on vascular endothelium function. Adropin is a newly discovered peptide that can increase by exercise and decreased in endothelial dysfunction. Objectives: Detecting the effect of practicing exercise on preeclampsia pathophysiology, and role of adropin. Patients and Methods: Twenty four adult female albino wistar rats were divided into 3 equal groups: group I: Sham-operated Time-mated pregnant rats (Sham), group II: Reduced uterine perfusion pressure pregnant rats (RUPP); placental ischemia was induced at gestation day (GD) 14 to mimic preeclampsia, and group III: exercise treated reduced uterine perfusion pressure pregnant rats (Ex-RUPP); swimming started from GD1 till the end of pregnancy period, 1h/day, 6 days/week added to preeclampsia induction. Maternal arterial blood pressure, micro-albuminuria, serum urea, creatinine and calculated glomerular filtration rate (GFR), plasma insulin, glucose and calculated HOMA-IR  and placental  eNOS, adropin, soluble fms–like tyrosine kinase 1 (sFlt-1), malondialdehyde (MDA), total antioxidant capacity (TAC), and TNF-α were measured. Placental and fetal tissues were weighed and placenta was histo-pathologically assessed. Results: Aerobic exercise during pregnancy caused significant reductions in all blood pressure values at GD17 and 19, serum urea, creatinine, micro-albuminuria, placental anti-angiogenic sflt-1, MDA, TNF-α, plasma glucose, insulin and HOMA-IR. In addition, exercise significantly increased the calculated creatinine clearance, placental eNOS and placental adropin, placental weight, fetal weight and number.    Apoptotic trophoblasts and neutrophil aggregates were absent. Adropin was significantly positive correlated with eNOS together with a significant negative correlation to mean arterial blood pressure at GD19, sflt-1, MDA, insulin and HOMA-IR. Conclusion: Aerobic exercise, through increasing adropin level, was able to restore the angiogenic balance, and to decrease the oxidative stress, and inflammatory and insulin resistance states, thus improving endothelial function. This was reflected in improvement in the renal functions, blood pressure reduction with better maternal and fetal outcome.