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Impaired trophoblast invasion, defective spiral artery remodeling, angiogenic imbalance, oxidative stress, and sterile inflammation collectively drive placental dysfunction and subsequent systemic endothelial injury. Current clinical management remains largely supportive, highlighting the urgent need for mechanism\u2010based therapeutic strategies that directly target the placenta while minimizing fetal risk. Nanomaterial\u2010based approaches offer unique advantages in this context, enabling selective placental delivery, controlled drug release, and precise modulation of pathogenic pathways. Recent advances have demonstrated the potential of placenta\u2010targeted nanomedicine to attenuate oxidative stress, suppress inflammatory signaling, restore angiogenic balance, and regulate gene expression within the placental microenvironment. This review summarizes key pathological features of placental dysfunction in preeclampsia, discusses design principles for pregnancy\u2010safe nanomaterials, and evaluates emerging therapeutic strategies and preclinical models. 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