Objective: To investigate the changes and the corresponding clinical value of serum cortisol levels in patients with hypertensive disorders during pregnancy. Methods: In this study, 90 patients with different degrees of hypertensive disorders during pregnancy who were admitted from August 2018 to August 2019 in our hospital were set as the research objects. 90 cases were grouped according to the diagnostic criteria in Obstetrics and Gynecology, including 30 cases in each of the hypertension group, the preeclampsia group, and the eclampsia group. Another 30 healthy pregnant women were selected as the control group. The serum cortisol levels of pregnant women in the above four groups were measured. Results: Compared with the control group, the serum cortisol levels in the other three groups were significantly increased. In perinatal outcome, compared with the control group, the three groups of patients had an increase in Apgar score, preterm birth, stillbirth rate, growth restriction rate and neonatal asphyxia rate. There were significant differences between groups (P <0.05), and showed as gestational hypertension <preeclampsia <eclampsia. Conclusion: With the exacerbation of hypertensive disorders during pregnancy, the serum cortisol level continues to increase, which has a serious adverse effect on the prognosis of the perinatal infants.