To investigate the predictive value of standardized uterine artery measurement of pregnant women during the first trimester of pregnancy for their gestational hypertension (GH) occurrence during the second and third trimester of pregnancy. Methods: 168 pregnant women with GH and preeclampsia (in observation group) and 121 normal pregnant women (in control group) who had delivery from July, 2020 to December 2020 were analyzed retrospectively. The women in the observation group were further divided into group A (women with chronic hypertension), group B (women with GH), group C (women with mild preeclampsia), group D (women with severe preeclampsia), and group E (women with early-onset preeclampsia of ≤32 gestational weeks). The standardized uterine artery measurements of these women were conducted by attending physicians or above after the specially trained. The uterine artery pulsatile index（PI）and the early diastolic notch situation of these women were recorded. The uterine artery PI value and the difference of diastolic notch of the women during the first trimester of pregnancy were compared among these groups. The predictive value of uterine artery PI value of the women during the first trimester of pregnancy for their GH was analyzed. Results: The PI value of the women during the first trimester of pregnancy in group A (1.88±0.51), in group B (1.91±0.51), in group C (1.90±0.51), in group D (1.89±0.55), or in group E (2.46±0.45) was all significantly higher than that (1.63±0.43) of the women in the control group (P<0.05), and which of the women in group E was significantly higher than that of the women in group A, group B, group C, or group D (all P<0.01). The age of the women in group E (33.5±5.6 years old) was significantly higher than that (29.6±3.5 years old) of the women in the control group (P<0.01), there was no significant difference in early diastolic notch situation of the uterine artery of the women between the observation group and the control group (P>0.05). When the 90th percentile of PI values of uterine artery of 2.4 and 2.8 during the first trimester of pregnancy was as the cut-off points for predicting GH and early-onset preeclampsia of ≤32 gestational weeks, the sensitivity were 27% and 32%, and the specificity were 97％and 97％. The positive predictive value and the negative predictive value for predicting GH were 92% and 84% when the PI value as the cut-off point was 2.4. The positive predictive value and the negative predictive value for predicting early-onset preeclampsia were 92% and 84% when the PI value as the cut-off point was 2.8. Conclusion: Standardized measurement of PI value of uterine artery of the pregnant women during the first trimester of pregnancy has good predictive value for their GH and early-onset preeclampsia occurrences during the second and third trimester of pregnancy.