Objective: To investigate the expression of serum UA and Hcy in patients with preeclampsia and their relationship with adverse pregnancy outcomes. Methods: 85 patients with preeclampsia treated in our hospital from July 2023 to July 2024 were selected as the observation group, and 85 healthy pregnant women who underwent physical examination in our hospital during the same period were selected as the control group. Serum uric acid (UA) and homocysteine (Hcy) levels were detected in both groups. Baseline data were collected and compared between the two groups. The pregnancy outcome of the observation group was statistically analyzed, and the observation group was further divided into adverse pregnancy outcome and normal pregnancy outcome according to the different pregnancy outcome. The baseline data of preeclampsia patients with different pregnancy outcomes were analyzed and compared. Logistic regression was used to analyze the influencing factors of adverse pregnancy outcomes in preeclampsia patients. Results: The levels of serum UA and Hcy in observation group were significantly higher than those in control group (P < 0.05). The incidence of adverse pregnancy outcomes in preeclampsia patients was 24.71% (21/85). The systolic blood pressure, diastolic blood pressure, 24h urinary protein, UA and Hcy of patients with adverse pregnancy outcome were significantly different from those with normal pregnancy outcome (P < 0.05). Logistic regression analysis showed that increased systolic blood pressure, increased diastolic blood pressure, 24h urinary protein, UA, Hcy and serum creatinine were independent risk factors for adverse pregnancy outcomes in preeclampsia patients (OR=1.094, 1.174, 1.061, 1.049, 1.135, 1.114, P < 0.05). Conclusion: Serum UA and Hcy levels are elevated in patients with preeclampsia, which is related to adverse pregnancy outcomes in patients with preeclampsia.