To explore the effect of low-dose aspirin(LDA) combined with vitamin D for treating pregnant women with high-risk pre-eclampsia(PE), and to study its influence on the coagulation indexes and prethrombotic state of the women. Methods: A total of 135 pregnant women with high-risk PE were selected and were divided into group A(45 women with the treatment of LDA combined with vitamin D), group B(45 women with the treatment of vitamin D) and group C(45 women without treatment) according to the different treatment methods between July 2019 and December 2023. The incidence of PE, the values of the coagulation indexes, such as prothrombin time(PT), activated partial thromboplastin time(APTT), fibrinogen(FIB) and D-dimer(D-D), the prethrombotic state evaluated by the values of thrombin antithrombin complex(TAT), plasminase-antiplasmin complex(PIC), thrombomodulin(TM) and tissue plasminogen activator-plasminogen activator inhibitor-1 complex(t-PAIC), the values of hemodynamic indexes of uterine artery, such as resistance index(RI) and pulsation index(PI), and the pregnancy outcomes of the women were compared among the three groups. The incidence of PE(11.1%) of the women after treatment in group A was significantly lower than that of the women in group B(31.1%) or in group C(33.3%). The values of APTT(30.34±2.00s) and PT(12.45±2.63s) of the women in group A after treatment were significantly higher than those of the women in group B(23.05±2.56s and 9.46±2.07s) or in group C(22.98±3.18s and 12.45±2.63s). The levels of FIB(3.24±1.03 g/L) and D-D(1.34±0.35 mg/L) of the women in group A were significantly lower than those of the women in group B(4.57±1.47 g/L and 2.53±0.42 mg/L) or in group C(5.25±1.36 g/L and 3.38±0.60 mg/L). The levels of TAT(9.81±1.89 ng/ml) and PIC(1.35±0.46μg/ml) of the women in group A were significantly lower than those of the women in group B(13.42±2.16 ng/ml and 1.66±0.58μg/ml) or in group C(14.15±2.30 ng/ml and 1.72±0.53μg/ml). The RI and PI values of the women in group A were significantly lower than those of the women in group B or in group C. The cesarean rate(33.3%) of the women and the incidence of the neonatal low birth weight(2.3%) in group A were significantly lower than those(55.6% and 15.6%) in group B or those(62.2% and 17.8%) in group C(P<0.05). Conclusion: The LDA combined with vitamin D for treating the pregnant women with high-risk PE can significantly improve their coagulation function, prethrombotic state and uterine artery hemodynamics, and thus can effectively prevent the occurrence of PE of the women and improve the maternal and neonatal outcomes.