Objective: To analyze the influence of homocysteine (Hcy) and insulin resistance on the pregnancy induced hypertension (PIH) occurance of women with gestational diabetes mellitus (GDM). Methods: All included pregnant women were divided in group A (42 women with GDM), group B (35 women with PIH), group C (28 women with GDM and PIH), and group D (56 normal pregnant women) from March 2014 to March 2018. The serum Hcy level and insulin resistance index (HOMA-IR) of women during 24-28 gestational weeks in the four groups were measured. Logistic regression analysis was used to summarize the related factors affecting the PIH occurance of women with GDM. Results: Before pregnancy, BMI value of women in group A and B was significant higher than that of women in group D, but was significant lower than that of women in group C. The levels of fasting plasma glucose (FPG) and fasting insulin (FINs), and HOMA-IR value of women in group A were significant higher than those of women in group B and D, but were significant lower than those of women in group A. The systolic blood pressure, diastolic blood pressure and Hcy level of women in group B were significant higher than those of women in group A and D, but were significant lower than those of women in group A ( all P<0.05). Logistic regression analysis showed that BMI, HOMA-IR value, and Hcy level were independent risk factors for PIH occurance of women with GDM (P<0.05). Conclusion: Both Hcy and insulin resistance are related to the pathogenesis of PIH, and abnormal Hcy level and insulin resistance are related to PIH occurance of pregnant women with GDM.