OBJECTIVES: Gestational diabetes mellitus (GDM) is associated with elevated risk of severe perinatal complications and type 2 diabetes (T2DM). Screening and intervention is recognized as an effective way to reduce these risks. The prevalence rate of GDM was as high as 17.5% in China, which caused a huge economic burden. GDM screening and intervention was reported in many hospitals in China, however, lacking evaluation from an economic perspective up to now. The objective was to estimate the long-term cost-effectiveness associated with GDM screening in the urban Chinese setting to provide economic evidence for clinical practice and policy making. METHODS: A published decision-analysis tool (the GeDiForCE^TM) was employed to assess cost-effectiveness of GDM screening by comparing costs and averted disability-adjusted life years (DALYs) with no GDM screening. As modeling inputs, costs for GDM screening and antenatal care, incidence and cost of GDM perinatal adverse effects (PAE) were based on an investigation on 6 tertiary hospitals from different cities in China as part of this analysis. Cost for postpartum care was calculated based on literature and adjusted for China. PAE-DALYs, life-time cost for postpartum T2DM, and effectiveness of interventions were collected from literature. Annual discount rate was 3.0%. One-way sensitivity analyses were conducted on some key indicators. RESULTS: The total costs of GDM screening, intervention and life-time treatment per 1000 pregnant women were $7,092,398 in GDM screening group, saving $1,329,671 comparing with no screening. 277.4 DALYs were averted in screening group, which was mainly brought out by GDM postpartum care for T2DM prevention. Sensitivity analyses demonstrated robustness of the results. CONCLUSIONS: GDM screening and interventions are cost-saving in an urban Chinese setting by IADPSG standards. As DALYs averted mainly comes from T2DM prevention, China should pay more attention to providing postpartum care for GDM women in the future.