Objective: To explore the predictive value of ultrasound blood flow parameters in late pregnancy on maternal-infant outcomes in pregnant women with gestational hypertension. Methods: 62 pregnant women with late pregnancy hypertension admitted from December 2023 to December 2024 were included as the study subjects, and blood flow parameters were measured using color Doppler. According to the delivery outcome, they were divided into a normal delivery group (n=40) and an abnormal delivery group (n=22). Compare two sets of ultrasound blood flow parameters and use binary logistics equations to analyze the factors related to adverse delivery outcomes in patients; Using ROC curve analysis to evaluate the predictive value of ultrasound blood flow parameters for adverse delivery outcomes. According to the perinatal outcomes, patients were divided into a normal perinatal outcome group (n=46) and an abnormal perinatal outcome group (n=16). The ultrasound blood flow parameters of the two groups were compared, and binary logistics equations were used to analyze the factors related to adverse perinatal outcomes in patients; Using ROC curve analysis to evaluate the predictive value of ultrasound blood flow parameters for adverse perinatal outcomes. Results: The PI, RI, S/D of the umbilical artery and uterine artery in the abnormal delivery group and the abnormal perinatal outcome group were higher than those in the normal delivery group and the normal perinatal outcome group, respectively (P<0.05), while the PI, RI, and S/D of the middle cerebral artery were significantly higher than those in the normal delivery group and the normal perinatal outcome group (P<0.05); The PI, RI, S/D of umbilical artery, uterine artery, and middle cerebral artery are associated with adverse delivery outcomes and adverse perinatal outcomes in patients with gestational hypertension (P<0.05); Using PI, RI, S/D of the umbilical artery, uterine artery, and middle cerebral artery as test variables, the ROC curve results showed that the AUC for predicting adverse delivery outcomes and adverse perinatal outcomes in patients with pre pregnancy hypertension were 0.730, 0.832, 0.836, 0.719, 0.700, 0.755, 0.798, 0.836, 0.719 and 0.706, 0.979, 0.921, 0.910, 0.737, 0.775, 0.900, 0.913, 0.992 respectively. Conclusion: Ultrasound blood flow parameters in late pregnancy can effectively predict maternal and infant outcomes in pregnant women with gestational hypertension, and have clinical value.