Objective: Clinically, pregnant woman of advanced maternal age has been considered as high -risk pregnancy women, and high-risk pregnancy have been associated with adverse clinical outcomes. Therefore, our study is to investigate the association between high -risk pregnancy and gestational diabetes mellitus risk in Chinese pregnant woman of advanced maternal age. Methods: A total of 196 pregnant woman at advanced maternal age were included, and high-risk pregnancy (HRP) score and oral glucose tolerance test were assessed in all subjects. Results: The clinical and laboratory data were separated into three groups according to HRP score, there were significant statistical differences in 1 hour postload plasma glucose levels and 2 hour postload plasma glucose levels (p = 0.007, p = 0.016, respectively). Interesting, HRP score was found to be positively correlated with fasting blood-glucose, 1 hour postload plasma glucose levels and 2 hour postload plasma glucose levels (r = 0.160, p = 0.025; r = 0.217, p = 0.002; r = 0.175, p = 0.014). Multiple linear regression analysis showed that HRP score still was independently correlated with 1 hour postload plasma glucose levels after adjusting for age, body mass index, gestational age, blood pressure, fasting blood-glucose and 2 hour postload plasma glucose (beta = 0.236, p = 0.001). Conclusion: HRP score is independently correlated with 1 hour postload plasma glucose levels, the results suggested that high-risk pregnancy may increase gestational diabetes mellitus risk in Chinese pregnant woman of advanced maternal age.