Abstract: Objective The present study was conducted to find out the relationship between the infection rate of Toxoplasma gondii and adverse pregnancy outcomes among pregnant women in Zhoushan Islands. Methods Enzyme linked immunoadsorbent assay (ELISA) was adopted to detect toxoplasma gondii antibody-IgG and IgM (ToxIgG/M) in the peripheral blood of 5686 pregnant women, and they were followed up to observe their pregnancy outcomes. Umbilical cord blood samplings were conducted to examine toxoplasma gondii antibody-IgM (ToxIgM) in 44 cases of malformed newborns and 188 normal newborns in the control group. Results In Zhoushan Region, 149 pregnant women were infected by Toxoplasma gondii, including 121(81.21%) cases with past infection and 28 (18.19%) new infection cases,and the average positive rate of infection was 2.62%. The incidences of spontaneous abortion, stillbirths and malformed newborns in the infection group were respectively 14 cases (9.39%) , 4 cases (2.68%) and 12 cases (8.05%), while they were respectively 47 cases (0.85%), 42 cases (0.76%) and 32 cases (0.58%) in the control group. And the difference between the two groups was statistically significant (P0.01). Relative risks (RR) in the infection group were: 12.11 of spontaneous abortion, 3.61 of stillbirths and 15.07 of malformed newborns. The positive rate of ToxIgM among the congenital malformed fetuses was 27.27%, while 0 in the control group. And this difference between the two groups was of statistical significance (P0.01). Conclusion Toxoplasma gondii infection in pregnant women can result in adverse pregnancy outcomes. However, as long as the pre-pregnant monitoring and health education of the women of childbearing age are strengthened, the adverse pregnancy outcomes of pregnant women infected by Toxoplasma gondii can be controlled.