To observe the efficacy of ademetionine1,4-butanedisulfonate (SAMe) combined with ursodeoxycholic acid (UDCA) for treating pregnant women with intrahepatic cholestasis of pregnancy (ICP). Methods: 130 pregnant women with ICP who were selected and were divided into two groups (65 cases in each group) by the random number table method between January 2018 and January 2021. The women in both groups were given routine symptomatic treatment and oral administration of UDCA for 3 weeks, and the women in the observation group were given intravenous injection of SAMe additionally for 3 weeks. The clinical effect, the symptom disappearance time, the liver function indexes levels before and 3 weeks after treatment, the bile metabolism indexes levels, the pregnancy outcomes, the perinatal infant condition, and the occurrence of adverse reactions during treatment of the women were compared between the two groups. Results: The relief time of pruritus or jaundice of the women in the observation group was significantly shorter than that of the women in the control group (P＜0.05). After 3 weeks of treatment, the levels of aspartate transferase (AST), alanine transferase (ALT), alkaline phosphatase (ALP), total bile acid (TBA), glycholic acid (CG), and estriol (E3) of the women in the two groups had decreased significantly, and which of the women in the observation group were significantly lower than those of the women in the control group (P＜0.05). The rates of premature delivery, cesarean section, and intrauterine distress of fetus of the women in the observation group were significantly lower than those of the women in the control group (P＜0.05), and the 1 min Apgar score of newborns in the observation group was significantly higher than that of the women in the control group (P＜0.05). There was no any woman with adverse reactions in both groups during treatment. Conclusion: SAMe combined with UDCA for treating the pregnant women with ICP can effectively relieve the symptoms of pruritus and jaundice, promote the liver function and bile metabolism, and reduce the adverse maternal and infant outcomes.