Objective To investigate he relationship between the serum leptin levels and carbohydrate metabolism in patients with pregnancy induced hypertension (PIH). Methods Serum leptin levels were measured by radio immunoassay in 46 patients with PIH (PIH group) and 40 normal pregnant women (control group). Fasting serum insulin (FINS) and fasting blood glucose (FBU) levels were determined, respectively. Insulin resistance index (HOMA-IR) and β-cell function index (HOMA-IS) were analyzed. Results Serum leptin levels in PIH women were significantly higher than those in normal pregnancy (t=8.100, P<0.01). Serum leptin levels in moderate PIH and severe PIH were higher than those in mild PIH women (F=8.312; q=3.82, 4.37; P<0.05). The levels of FINS, HOMA-IR and HOM-IS in PIH group were significantly higher than those in normal pregnancy group (t=3.242-7.588, P<0.01). Serum glucose levels had no significant difference between different groups (F=2.013, P>0.05). The levels of leptin in PIH were correlated to the levels of FINS, HOMA-IR and HOMA-IS (r=0.542-0.583, P<0.01). Conclusion Both insulin secretion and insulin resistance are elevated in PIH, and correlate to the increased serum levels of leptin.