This research investigated the effect of Piliostigma thonningii leaf extract on maternal and offspring lipid profiles following acetaminophen-induced toxicity in Wistar rats. Twenty-five pregnant rats (180-200 g) were assigned based on their body weight to groups I-V and treated thus: animals in groups II-V were orally administered 200 mg/kg b.w acetaminophen, 200 mg/kg b.w. P. thonningii, 100 mg/kg b.w. P. thonningii +200 mg/kg b.w. acetaminophen, and 200 mg/kg P.thonningii + 200 mg/kg b.w. acetaminophen, respectively, while group I served as the control. Lipid profile assay was performed after 28 days of animal experimentation. We observed that the maternal triglyceride (TG) and HDL concentrations of group II were significantly (P<0.001) higher and lower respectively than the control and test groups, while the TG and HDL of group II offspring were significantly higher (P<0.05) than the control and group V and lower (P<0.01) than control and test groups, respectively. The maternal total cholesterol (TC) concentration of group II was significantly reduced to normal in groups IV (P<0.001) and V (P<0.01) and for LDL of groups IV (P<0.001) and V (P<0.05). The TC of group II offspring was significantly reduced in groups IV (P<0.05) and V (P<0.001) of the offspring but LDL was not altered. This report revealed that P. thonningii leaf extract reverses acetaminophen-induced toxicity in pregnancy, which is reflected in dyslipidemia vis-à-vis pregnancy-induced hypertension (PIH). Hence, P. thonningii leaf extract possesses the potential to reverse PIH and related effects on offspring with a possible reduction in the risk of preeclampsia.