〔Abstract〕 Objective To evaluate the value of fetal umbilical artery (UA) and middle cerebral artery (MCA) blood flow parameters in predicting fetal distress by ultrasonography. Methods A total of 100 pregnant women in late pregnancy who were examined in Maternal and Child Health Hospital of Yunfu from June 2021 to September 2022 were selected as the study objects, 50 pregnant women with clinical diagnosis of fetal distress were set as the observation group, and 50 pregnant women with no abnormal fetuses were set as the control group. The UA and MCA blood flow parameters of all fetuses were measured, and the resistance index (RI), pulsatility index (PI), the ratio of peak systolic velocity/end diastolic velocity (S/D) were recorded and compared between groups. Results The RI, PI and S/D of fetal UA in the observation group were higher than those in the control group, RI and PI of MCA were lower than those of the control group, and the differences were statistically significant (P < 0.05). The RI ratio and PI ratio of MCA and UA in the observation group were lower than those in the control group, and the differences were statistically significant (P < 0.05). Conclusion Detecting fetal UA and MCA blood flow resistance indexes can reflect fetal hypoxia in utero and predict the occurrence of fetal distress.