Objective To investigate the value of morphological abnormalities of uterine artery on Doppler ultrasound combined with serum CC chemokine ligand 19（CCL19） level in predicting adverse pregnancy outcomes （APO） in patients with systemic lupus erythematosus （SLE）. Methods Eighty pregnant women with SLE were selected from January 2015 to January 2022 in Qingdao Women and Children′s Hospital and divided into APO group （34 women） and non-APO group （46 women） according to their pregnancy outcomes. The morphology of uterine artery on Doppler ultrasound and serum CCL19 level were compared between the two groups. The correlation and predictive efficacy of the combined detection with APO in SLE patients were analyzed. Results As compared with non-APO group， APO group had an increase in morphological abnormalities of uterine artery and serum CCL19 level （P < 0.05）. Logistic risk regression showed that the morphology of uterine artery and serum CCL19 were risk factors for APO in patients with SLE （P < 0.05）. The ROC curve showed that the optimal cut-off point for serum CCL19 to predict APO in patients with SLE was 335.89 ng/L， and the area under curve （AUC） for predicting APO in patients with SLE was 0.816. The AUC for morphological abnormalities of uterine artery on Doppler ultrasound to predict APO in patients with SLE was 0.694. The AUC for the combined prediction was 0.858. Conclusions Morphological abnormalities of uterine artery on Doppler ultrasound and serum CCL19 level are risk factors for APO in patients with SLE， and their combined detection has a higher predictive efficacy.