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Objective To explore the relationship between the serum level of placental growth factor (PLGF) and ultrasonic blood flow parameters and pregnancy outcome in patients with late-onset preeclampsia (LOPE). Methods A total of 152 patients with LOPE were selected and divided into the P1 (＜ 12.00 ng/L) group, the P2 (12.00-56.73 ng/L) group, the P3 (＞56.73-89.41 ng/L) group and the P4 (＞ 89.41 ng/L) group according to serum level of PLGF. There were 38 cases in each group. The clinical data, uterine artery pulsatility index (PI), resistance index (RI), peak systolic velocity (S)/ end-diastolic velocity (D) and adverse pregnancy outcome were compared between the four groups. The relationship between PLGF level and clinical characteristics was analyzed by linear regression analysis. The influence of LOPE severity on the relationship between PLGF and ultrasonic blood flow parameters was analyzed by stratified interactive analysis. Multivariate generalized linear mixed effect model was used to analyze the relationship between PLGF level and adverse pregnancy outcome in patients with LOPE. Results The diastolic blood pressure, 24 h urinary protein, PI, RI and S/D decreased significantly with the increase of PLGF level (P＜0.05). The proportion of severe LOPE and systolic blood pressure were significantly higher in the P1 group than those of the other groups (P＜0.05), and the above indexes were influencing factors of the level of PLGF (P＜0.05). The results of stratified interactive test showed that the LOPE severity did not affect the relationship between PLGF and ultrasonic blood flow parameters. There were significant differences in the incidence of HELLP syndrome, fetal growth restriction, fetal distress, premature delivery and neonatal asphyxia between patients with different PLGF levels (P＜0.05). The incidence of preterm delivery was higher in the P1 group than that in the other groups, and the other adverse pregnancy outcomes were higher in the P3 group and P4 group. Conclusion Serum PLGF levels affect uterine artery blood flow parameters and adverse pregnancy outcome in patients with LOPE. [ABSTRACT FROM AUTHOR]