Objective To investigate the relationship between serum nesfatin-1 and gestational diabetes mellitus (GDM). Methods The serum nesfatin-1 concentrations were measured in 45 GDM patients and 44 NGT pregnant women , as well as 47 non-pregnant healthy women served as control. Serum nesfatin-1 were measured by sandwich enzyme linked immunosorbent assay (ELISA). Meanwhile FPG、 lipoid、 FFA、 FINS、 C-tide were also measured. Result Serum nesfatin-1 level in GDM were significantly higher in GDM patients than in NGT and control (P < 0.01), while serum nesfatin-1 in NGT was significantly lower than in control (P < 0.01). Correlation analysis showed that serum nesfatin-1 was positively correlated with FINS , C-tide , HOMA-IR , triglycerides FBG and OGTT 1 hour glucose, HbA1c (P < 0.05). Conclusion Serum nesfatin-1 level in pregnant women significantly decreas, while in GDM patients significantly increase. Serum nesfatin-1 level in pregnant women is positively correlated with Insulin resistance (IR) and triglycerides level.