OBJECTIVE: This study aimed to ascertain serum bile acid levels and explore the diagnostic value of differential bile acids in patients with intrahepatic cholestasis of pregnancy (ICP). METHODS: 94 cases of ICP patients admitted to Wenzhou People's Hospital from Oct 2020 to July 2023 were selected as the ICP group, and 184 women who underwent normal prenatal examination in the same period as the healthy control group. The baseline data and 15 kinds of serum bile acid spectrum characteristics of the two groups of pregnant women were compared, and the risk factors of serum bile acid spectrum causing ICP were analyzed by univariate and multivariate logistic regression. A logistic regression model was constructed based on significant risk factors, and ROC curve was drawn to evaluate the diagnostic effect of the model. RESULTS: Compared with the healthy control group, the other 14 serum bile acids except LCA were highly expressed in the ICP group, and there was significant difference ( CONCLUSION: TCA and DCA indicators are closely related to the occurrence of ICP, and the combined detection of TCA and DCA can significantly improve the efficiency of ICP diagnosis.