To investigate the correlation between the plasma adiponectin (ADP) and homocysteine (HCY) levels of pregnant women with preeclampsia and their fetal growth and development. Methods: 126 pregnant women with preeclampsia between January 2019 and December 2020 were collected retrospectively. According to the fetal gestational weeks when born and the neonatal birth weight, these women were divided 30 women with neonatal small for gestational age (SGA) in group A, 71 women with neonatal appropriate for gestational age (AGA) in group B, and 25 women with neonatal large for gestational age (LGA) in group C. Meanwhile, 42 healthy pregnant women with the healthy AGA fetus were selected in group D. The levels of plasma ADP and HCY of the women during the third trimester of pregnancy in the four groups were tested. The neonatal birth height, birth weight, and birth head circumference of the neonates in the four groups were measured after born. The correlation between the plasma ADP and HCY levels of the women with preeclampsia and their neonatal growth parameters values was analyzed. Logistic regression analysis was used to analyze the factors influencing fetal intrauterine growth retardation. Results: The birth length, birth weight, and birth head circumference of the neonates in group A were significantly lower than those of the neonates in the other three groups, the plasma ADP level of the neonates in group A was significantly lower, and the plasma HCY level of the neonates in group A was significantly higher (all P＜0.05). The birth length, birth weight, and birth head circumference of the neonates of the pregnant women with preeclampsia were positively correlated with their plasma ADP level, and were negatively correlated with their plasma HCY level (P＜0.05). The high plasma ADP level of the women was a protective factor for their fetal intrauterine growth retardation (OR=0.386), but the high plasma HCY level was a risk factor for their fetal intrauterine growth retardation (OR=4.063). Conclusion: The levels of ADP and HCY of the pregnant women with preeclampsia are abnormal, and which are closely related to their fetal growth and development. The high HCY level and the low ADP level of the pregnant women with preeclampsia may increase the risk of their fetal intrauterine growth retardation.