To explore the levels of serum interleukin (IL)-6, IL-17 and IL-23 of pregnant women with hepatitis B surface antigen (HBsAg) positive and their neonates, and to study their correlation with the neonatal hepatitis B virus (HBV) intrauterine infection. Methods: The clinical data of 140 pregnant women with HBsAg positive (in study group) between January 2021 and December 2023 were collected retrospectively. According to the detection results of the HBsAg in the neonatal cord blood, the pregnant women in the study group were divided into group A (28 women with neonatal HBV intrauterine infection) and group B (112 women without neonatal HBV intrauterine infection). Another 140 pregnant women with HBsAg negative were enrolled in control group during the same period. The levels of serum IL-6, IL-17 and IL-23 in peripheral blood of the women and in neonatal cord blood serum were compared among these groups. Receiver operating characteristic (ROC) curve analysis was used to analyze the clinical value of the serum IL-6, IL-17 and IL-23 levels of the pregnant women with HBsAg positive for evaluating their neonatal HBV intrauterine infection. Results: The levels of the serum IL-6 (104.33±24.92 ng/L), IL-17 (282.65±76.71 ng/L) and IL-23 (269.52±64.28 ng/L) of the women in group A were significantly higher than those (70.34±18.61 ng/L, 123.41±43.02 ng/L and 113.75±41.68 ng/L) of the women in group B and those (68.13±17.18 ng/L, 119.53±37.13 ng/L and 110.32±44.43 ng/L) of the women in the control group (all P<0.05). There were no significant differences in the the serum IL-6, IL-17 and IL-23 levels of the women between group B and the control group (P>0.05). There were no significant differences in the IL-6, IL-17 and IL-23 levels in umbilical cord of the neonates among the three groups (P>0.05). ROC curve analysis showed that the area under the curve of the serum IL-6 level, the IL-17 level and the IL-23 level of the pregnant women with HBsAg-positive for evaluating their neonatal HBV intrauterine infection were 0.791, 0.725 and 0.745, respectively, the sensitivity and specificity of which were 61.6%-78.6%, and all of which had certain clinical reference values for evaluating their neonatal HBV intrauterine infection. Conclusion: The levels of serum IL-6, IL-17 and IL-23 of the pregnant women with the neonatal HBV intrauterine infection increase, and all of which have certain clinical guiding value for evaluating the risk of the neonatal HBV intrauterine infection of the women.