Objective: To investigate the clinical value of serum adiponectin in patients with preeclampsia and its relationship with insulin resistance. Methods: From May 2017 to May 2018, 80 cases of preeclampsia diagnosed and treated in obstetrics department of the Second People′s Hospital of Liaocheng were selected in the research.According to the severity of the disease, they were divided into severe preeclampsia group and mild preeclampsia group, with 40 cases in each group, and 40 healthy pregnant women in the same period were selected as the control group.The serum adiponectin level and insulin resistance index (HOMA-IR) were detected and compared among the groups, and the correlation between them was analyzed. Results: The serum adiponectin and HOMA-IR in the severe preeclampsia group were (5.08 ±1.13)mg/L, (3.08 ±1.54), respectively, which in the mild preeclampsia group were (6.55±1.46)mg/L, (2.62±1.34), respectively, which in the control group were (11.67±3.53)mg/L, (1.13±0.53), respectively.there were statistically significant difference among the three groups (all P<0.05). The serum adiponectin level in the severe preeclampsia group was lower than that in the mild preeclampsia group and control group(P<0.05), and the HOMA-IR in the severe preeclampsia group was higher than that in the mild preeclampsia group and control group (P<0.05). The serum adiponectin level in the mild preeclampsia group was lower than that in the control group, and the HOMA-IR was higher than that in the control group, the differences were statistically significant (all P<0.05). The serum adiponectin level of preeclampsia patients with insulin resistance was (4.89±1.25)mg/L, which was significantly lower than that of non-insulin resistance patients[(6.78±1.75)mg/L], and the difference was statistically significant (t=6.254, P<0.05). Pearson correlation analysis showed that serum adiponectin level was negatively correlated with HOMA-IR (r=-0.617, P<0.05). Conclusion The serum adiponectin level and insulin resistance index of preeclampsia patients are significantly decreased, and there is a significant negative correlation between them.