Objective To evaluate the clinical efficacy of compound Danshen injection in combination with nifedipine for hypertensive disorders of pregnancy and to investigate its regulatory effects on oxidative stress and vascular endothelial function. Methods This prospective， controlled study recruited 90 consecutive patients with hypertensive disorders of pregnancy who were admitted to the Department of Obstetrics at Langfang Maternal and Child Health Hospital from January 2023 to January 2025. The participants were randomly allocated to either a control group （n = 45）， which received nifedipine monotherapy， or an observation group （n = 45）， which was administered nifedipine in combination with compound Danshen injection. The treatment efficacy， serum levels of superoxide dismutase （SOD） and endothelin-1 （ET-1）， 24-hour urinary protein quantification， blood pressure ［systolic blood pressure （SBP）， diastolic blood pressure （DBP）］， and umbilical artery hemodynamic parameters ［systolic/diastolic ratio （S/D）， resistance index （RI）， and pulsatility index （PI）］ were compared both before and after treatment. Adverse pregnancy outcomes were also documented. Results The overall response rate was significantly higher in the observation group than in the control group （95.56% vs. 80.00%， P < 0.05）. After treatment， both groups showed increased SOD levels and decreased ET-1 levels， and the degree of improvement was significantly greater in the observation group （P < 0.05）. The observation group had significantly greater reductions in SBP， DBP， and 24-hour urinary protein levels （P < 0.05）. Moreover， compared with the control group， the observation group had larger decreases in PI， RI， and S/D after treatment （P < 0.05）. The incidence of adverse pregnancy outcomes was significantly lower in the observation group （P < 0.05）. No serious drug-related adverse reactions were observed in either group during the treatment period. Conclusions Treatment with Compound Danshen injection in combination with nifedipine significantly facilitated blood pressure stabilization and enhanced oxidative stress and endothelial function indices in patients with hypertensive disorders of pregnancy. Therefore， this combination therapy may represent a more effective and clinically valuable intervention compared to conventional treatment alone.