Preston's personal hobby of recreational tree climbing is introduced in his book (2007) The Wild Trees.. This climbing experience helped him write about the largest known redwoods like Lost Monarch in the Grove of Titans, or Iluvatar, described in that book along with delicate forest canopy ecosystems.
His 1992 New Yorker article "Crisis in the Hot Zone" was expanded into his best known book, The Hot Zone (1994). It is a "non-fiction thriller" about the Ebola virus. He came to know the virus through such contacts as U.S. Army researchers Drs. C.J. Peters and Nancy Jaax. His fascination began during a visit to Africa where he was an eyewitness to epidemics.
Preston's novel The Cobra Event (1998), about the terroristic release of a fictional virus combining various qualities of different diseases upon New York City, alarmed even then-President Bill Clinton who, shortly after reading it, instigated a review of bio-terror threats to the U.S. The book strove to tell a fast-paced thriller narrative within the bounds of well-researched bio-terroristic possibility, and was reportedly pressed upon Clinton by a molecular biologist when he was attending a Renaissance Weekend event.
The Demon in the Freezer (2002) covers the story of the eradication of smallpox, perhaps the most destructive virus to have plagued mankind. It details the survival of the virus in research labs and bio-weapon programs of Russia and other nations, despite its eradication in the human population. The narrative continues with Anthrax, a bacterial disease of cattle and humans, used in a failed attack against former Senator Tom Daschle of South Dakota.
The Hot Zone served as the (very loose) basis of the Hollywood movie Outbreak (1995) about military machinations surrounding a fictional "Motaba virus".
First Light, American Steel and The Wild Trees are non-fiction on completely different topics, addressing astrophysics, the steel industry and California Redwoods respectively.
He currently resides in Hopewell, NJ with 2 daughters and 1 son who is in the 2012 class of The Lawrenceville School.