To evaluate the clinical value of soluble vascular endothelial growth factor receptor-1/placental growth factor ratio (sFlt-1/PlGF) combined with D-dimer (D-D) level of pregnant women for evaluating the risk of their preeclampsia occurrence and pregnancy outcomes. Methods: A total of 90 pregnant women with preeclampsia who were admitted to the department of obstetrics were selected in study group and 90 normal pregnant women were selected in control group from January 2022 to January 2024. The women in the study group were divided in group A (women with mild preeclampsia) and group B (women with severe preeclampsia). The serumsFlt-1 and PlGF levels of the women in the two groups were measured by fluorescence immunoassay, and the D-D level of the women in the two groups was measured by a coagulometer. The serum sFlt-1, PlGF and D-D levels of the women in the study group were compared among the women with the different preeclampsia conditions and among the women with the different pregnancy outcomes. The predictive value of the sFlt-1/PlGF ratio combined with the D-D level of the pregnant women for their preeclampsia and the correlation between the sFlt-1/PlGF ratio and the D-Dimer level of the women and their pregnancy outcomes were analyzed. Results: The levels of serum sFlt-1, sFlt-1/PlGF and D-D of the women in group A and in group B were significantly higher than those of the women in the control group, and the level of PlGF of the women in group A and in group B was significantly lower than that of the women in the control group. The serum levels of sFlt-1 and D-D, and the sFlt-1/PlGF ratio of the women in the control group, in group A and in group B had increased gradually, and the PlGF level of them had decreased gradually. In the study group, the serum levels of sFlt-1 and D-D, and sFlt-1/PlGF ratio of the women with the adverse pregnancy outcomes were significantly higher than those of the women with the normal pregnancy outcomes, and the PlGF level of the women with the adverse pregnancy outcomes was significantly lower (all P<0.05). The area under the curve (0.880) and the sensitivity (0.84%) of the combined levels of the serum sFlt-1, PlGF and D-D, and the sFlt-1/PlGF ratio of the women for predicting their PE were significantly higher than those of the serum sFlt-1 level, the PlGF level, the D-D level, or the sFlt-1/PlGF ratio alone (P<0.05). The levels of serum sFlt-1 and D-D, and the sFlt-1/PlGF ratio of the women with PE were positively correlated with their adverse pregnancy outcomes, and the level of PlGF of the women with PE was negatively correlated with their adverse pregnancy outcomes (all P<0.05). Conclusion: The combined levels of the serum sFlt-1, PlGF and D-D, and the sFlt-1/PlGF ratio of the women for predicting their PE has better value, and the levels of serum sFlt-1 and D-D, and the sFlt-1/PlGF ratio of the women with PE are correlated with their adverse pregnancy outcomes.