To explore the blood glucose level during pregnancy and the adverse pregnancy outcomes of pregnant women with chronic hepatitis B virus (HBV) infection. Methods: 256 pregnant women admitted to the hospital were selected as the study objects from January 2021 to November 2023. These women were divided into group A (106 women without HBV infection), group B (100 women with HBV infection and without antiviral therapy) and group C (50 women with chronic HBV infection and antiviral therapy). The levels of the blood glucose indexes of the women in the three groups were measured, and the pregnancy outcomes of the women in the three groups were evaluated. The values of the blood glucose indexes levels of the women with chronic HBV infection for predicting their adverse pregnancy outcomes were analyzed by receiver operator characteristic (ROC) curve. Results: The levels of 2h postprandial blood glucose, fasting blood glucose and glycosylated hemoglobin of the women in group A, in group B and in group C had increased gradually. The incidences of the maternal and neonatal complications in group B and in group C were significantly higher than those of the women in group A (P<0.05). In group C, the levels of 2h postprandial blood glucose, fasting blood glucose and glycosylated hemoglobin of the women with adverse pregnancy outcomes were significantly higher than those of the women with normal pregnancy outcomes (P<0.05). ROC analysis showed that the area under the curve of the levels of 2h postprandial blood glucose, fasting blood glucose and glycosylated hemoglobin of the women with HBV infection for predicting their adverse pregnancy outcomes were 0.832, 0.753 and 0.784, respectively, and the area under the curve of the combined levels of 2h postprandial blood glucose, fasting blood glucose and glycosylated hemoglobin of the women with HBV infection for predicting their adverse pregnancy outcomes was 0.925. Conclusion: The blood glucose level of the pregnant women with HBV infection increases abnormally, and which is related to the occurrence of their adverse pregnancy outcomes. The values of the combined levels of the blood glucose indexes of the women for predicting their adverse pregnancy outcomes is better.