Preeclampsia (PE) is characterized by new-onset hypertension after 20 weeks of gestation, and can be associated with multiple systemic organ damages, the pathogenesis of which has not yet been fully elucidated so far. Necroptosis is a newly defined form of programmed cell death in recent years that is closely related to tumor development and cardiovascular and nervous system degeneration, etc. A recent study reported that women diagnosed with PE exhibited enhanced necroptosis in their trophoblasts. However, the regulatory factors involved in trophoblast necroptosis remain poorly understood. In our previous work, we sequenced the microRNAs (miRNAs) in fetal exosomes (i.e., exosomes in cord blood) and found that 11 significantly down-regulated miRNAs, such as miR-3196, miR-197-3p, and miR-5787 etc., may be involved in the regulation of necroptosis by negatively targeting the key gene receptor interacting serine /threonine protein kinase 1 in the necroptotic pathway. Herein, we rationalize the hypothesis that fetal exosomal miRNAs may play a key role in regulating trophoblast necroptosis and thus, participate in the occurrence and development of PE. We hope that this article will lead to an improved understanding of fetal role in the pathogenesis of PE.