Objective <p>To investigate the prescribing patterns of antihypertensive drugs for hypertensive disorders of pregnancy (HDP) in hospitals across nine chinese cities from 2019 to 2024.</p> Methods <p>Medication use data for HDP patients were extracted from the database of the Hospital Pharmacy Committee of the Chinese Pharmaceutical Association, covering hospitals in nine major cities across China. The analysis included indicators such as total number of prescriptions, patient age, regional, average prescription cost, defined daily doses (DDDs), defined daily cost (DDC), and B/A ratio (ranking ratio). Furthermore, patterns of combination therapy and prescription rationality were assessed.</p> Results <p>Between 2019 and 2024, HDP patients were concentrated in the age of 30–34 years and in the North China region. Among outpatients, the top three antihypertensive drugs were oral labetalol (75.90%), oral nifedipine (17.42%), and oral methyldopa (3.36%). Among inpatients, the top three antihypertensive drugs were oral nifedipine (42.69%), oral labetalol (38.86%), and nicardipine for injection (5.84%). In outpatient, monotherapy accounted for 90.77%, followed by dual therapy (8.99%). Among inpatients, monotherapy constituted 60.01%, dual therapy accounted for 37.33%. Among drugs ranked high in terms of DDDs, oral labetalol had a B/A ratio of 1, with a daily cost of 12.31 CNY; oral nifedipine had a B/A ratio &gt; 1, with a daily cost of 1.03 CNY; and nicardipine for injection had a B/A ratio &lt; 1, with a daily cost of 474.41 CNY.</p> Conclusion <p>The use of antihypertensive drugs in patients with HDP is gradually aligning with guideline-recommended treatment strategies.</p>