OBJECTIVES: The incidence of gestational diabetes (GDM) is increasing in China. Understanding the changes in the health-related quality of life (HRQOL) during pregnancy is essential to assess the efficacy of the initial GDM treatment strategy. We aimed to investigate the HRQOL in women with gestational diabetes in China and to examine which patient characteristics are associated with quality of life. METHODS: A cross-sectional study was conducted in a university hospital, one of the largest public healthcare provider in South China. A sample of 233 EQ-5D-5L and medical records of women at their antenatal clinic visit during August 2016 to December 2016 were recorded. Outcome measures included HRQOL and pregnancy-related complications. RESULTS: We collected 233 women data (Age 32.8±5.55, gestational age 34.17±5.15 weeks). Of the 233 inpatient cases, 25 were diagnosed with GDM (10.7%). Mean HRQOL was 0.87±0.12 in the GDM group with initial treatment and 0.83±0.14 in the non-GDM group (P=0.16). Multipara was significantly associated with high (≥75th percentile) HRQOL (OR 2.06; 95% CI 1.20-3.54). Mean HRQOL was 0.86±0.14 for multipara and 0.81±0.13 for primipara (P<0.01). In reverse, multiple births with a lower HRQOL 0.78±0.10 (P<0.01). CONCLUSIONS: The mean HRQOL was higher in the GDM group that had undergone initial treatment than in the non-GDM group, which means the efficacy of the initial GDM treatment was high and the HRQOL outcomes even better those of the healthy pregnancy group. The lifestyle modification and diet advice could be potentially useful for pregnant women. However, we should conduct a multi-center study with a larger sample size to support the findings. Multipara was associated with a high HRQOL whereas primipara and multiple births were related to a relatively lower HRQOL in Chinese women during pregnancy.