Objective: To assess prenatal Bisphenol A (BPA) exposure levels and explore their preliminary associations with maternal and fetal characteristics in a population from Northeastern Yunnan. Methods: A cross-sectional analysis was performed using data and urine samples from 70 pregnant women in their third trimester recruited at Qujing Central Hospital. Urinary BPA was measured by HPLC-MS/MS. Participants were stratified into high and low BPA exposure groups based on the median concentration. Results: BPA was detected in all samples (100%) with a median concentration of 2.41 μg/L (IQR: 0.68–4.96). The high BPA exposure group (≥ 2.41 μg/L) had a significantly higher proportion of gestational diabetes mellitus (GDM) (42.9% vs. 17.1%, p = 0.021) and a lower median fetal birth weight (3250 g vs. 3450 g, p = 0.048) compared to the low exposure group. Conclusion: This pilot study reveals ubiquitous BPA exposure in pregnant women from Northeastern Yunnan. The observed preliminary associations with GDM and reduced fetal birth weight warrant further investigation in larger, longitudinal studies.