To analyze the value of uterine artery blood flow parameters combined with serum free fatty acid (FFA) for predicting the pregnant women with early onset preeclampsia (EOPE) and intrauterine growth restriction (FGR). Methods: 296 pregnant women with EOPE were selected as research objects and were divided into group A (women with EOPE only) and group B (women with EOPE and FGR) according to the occurrence of FGR from January 2017 to September 2019. The values of S/D, RI, and PI of uterine artery, and serum FFA level of the women were compared between the two groups. The correlation between serum FFA level and the values of S/D, RI, and PI of uterine artery was analyzed. The value of FFA level combined with uterine artery parameters for predicting EOPE and FGR was discussed. Results: The serum FFA level of the women in group B (0.78±0.20 mmol/mL) was significant higher than that (0.65±0.18 mmol/mL) of the women in group A, and the value of S/D (3.75±0.98), RI (0.73±0.20) and PI (1.02±0.24) of the women in group B were also significant higher than those of the women in group A (all P<0.05). Serum FFA level was positively correlated with S/D, RI and PI values (r=0.306, 0.686, 0.577, P<0.05). ROC curve analysis showed that serum FFA value and uterine artery blood flow parameters (S/D, RI and PI values) had effect for predicting EOPE and FGR. The FFA level combined with  S/D, the FFA level combined with  PI value, and the FFA level combined with RI value all had effect for predicting EOPE and FGR, among them, the FFA level combined with RI value had the best predictive efficacy, which’s AUC, sensitivity, the specificity were 0.906, 78.7, and 84.3%, respectively. Conclusion: The serum FFA level combined with uterine artery RI value has ideal efficacy for predicting EOPE and FGR.