〔Abstract〕 Objective To explore the risk factors of hypertensive disorder complicating pregnancy (HDCP) in polycystic ovary syndrome (PCOS). Methods A total of 148 pregnant women with PCOS admitted to the First Affiliated Hospital of Zhengzhou University from May 2019 to July 2021 were selected as the study objects. According to whether the patients had HDCP or not, they were divided into HDCP group (78 cases) and non-HDCP group (70 cases). According to the literature and clinical experience of doctors, the factors that may affect the complication of HDCP in pregnant women with PCOS were selected. Logistic univariate and multivariate regression analysis were performed successively to determine the independent factors affecting HDCP in pregnant women with PCOS. Results Univariate analysis showed that pre-pregnancy body mass index (BMI), family history of hypertension, family history of HDCP, history of passive smoking, pre-pregnancy testosterone and fasting insulin levels in HDCP group were higher than those in non-HDCP group, education background and monthly family income were lower than those in non-HDCP group, and the differences were statistically significant (P < 0.05). Multivariate logistic regression analysis showed that high pre-pregnancy BMI, family history of hypertension, family history of HDCP, high pre-pregnancy testosterone level and high fasting insulin level were all risk factors for HDCP in pregnant women with PCOS, and high education and monthly family income were protective factors for HDCP in pregnant women with PCOS (P < 0.05). Conclusion Family history of blood pressure and HDCP may increase the risk of HDCP in pregnant women with PCOS. Active reduction of BMI and monitoring of testosterone and insulin during pregnancy can help reduce the risk of HDCP.