Objective To investigate the value of placental blood perfusion monitoring in drug treatment of pregnant women with gestational hypertension. Methods 228 patients with gestational hypertension in our hospital from 2016 to 2018 were selected，including 93 patients with mild preeclampsia and 145 patients with severe preeclampsia. All patients received conventional drug treatment，while normal pregnant women were selected as the control group. Three dimensional power Doppler ultrasound was used to evaluate the efficacy of placental blood perfusion monitoring. Results The hemorheological indexes of VI，fi，VFI，s/d of umbilical artery were significantly different in the three groups before treatment，and there was no significant difference in hemorheological indexes of the three groups. Before treatment ，the ultrasound parameters of the women in Group A and Group B were significantly lower than those of the control group，and the Pi of the left and right uterine arteries in Group B was significantly lower than that of Group A，while the scores of PI and Apgar in the middle cerebral artery of Group B were significantly higher than those in Group A（P < 0.05）. There was no significant correlation between F1，2D color Doppler index and Apgar score，but there was significant correlation between placental V1，placenta VFI， 2D color Doppler index and Apgar score. The total effective rate of Group A and Group B was 96.77% and 95.56%， respectively. After drug treatment，placenta VI，FI and VFI showed significant differences under different therapeutic grades. Conclusion The monitoring of placental blood flow by three⁃dimensional power Doppler ultrasound can effectively evaluate the drug treatment effect of pregnant women with gestational hypertension，and has strong clini⁃ cal application value.