Abstract: Objective To analyze the value of color Doppler flow imaging(CDFI)combined with fetal non-stress test(NST)in the diagnosis of fetal distress in high-risk pregnant women with 37 to 42 gestational weeks. Methods Totally 100 high-risk pregnant women were selected and conducted with CDFI and NST detections. Taking the results of postpartum delivery as the gold standard, the results of single detection and combined detection were compared. Results There were 39 cases with positive result detected by CDFI, 39 cases with positive result detected by NST, and 31 cases with positive result detected by CDFI and NST. The sensitivity, specificity and accuracy of combined detection of CDFI and NST were significantly higher than those of CDFI or NST(P<0.05). All the pregnant women were divided into three groups according to gestational weeks, including 39 cases in group A(37 weeks to 40 weeks plus 6 days), 32 cases in group B(41 weeks to 41 weeks plus 6 days), and 29 cases in group C(42 weeks). The incidence of fetal distress in the group B was 87.50%(28/32), which was significantly higher than 79.31%(23/29)in the group C and 48.72%(19/39)in the group A, and was significantly higher in the group C than that in the group A(P<0.05). The incidence of adverse pregnancy outcomes in the group A was significantly lower than that in the group B and the group C(P<0.05). Conclusion CDFI combined with NST has a significant effect in the diagnosis of prenatal fetal distress in high-risk pregnant women with 37 to 42 gestational weeks, which can increase the detection accuracy and guide early clinical intervention.