Objective To study the pregnancy complication incidences, delivery manners and pregnancy outcomes of senile pregnant women. Methods The medical records of 10 508 cases of pregnant and delivery women, who were hospitalized for delivery in Obstetrical Department of Changhai Hospital of Second Military Medical University from Jan. 2010 to Dec. 2016, were collected and analyzed. According to delivery age, they were divided into the senile group (≥ 35 years old, n=1 130) and the non-senile group (<35 years old, n=9 378). Chi-square test was used to compare the incidences of pregnancy complications, cesarean section rate, ratio of cesarean section indications and outcomes of maternal and perinatal infants between the two groups. Results The proportion of senile pregnant women increased from 6.75% (89/1 319) in 2010 to 15.82% (267/1 688) in 2016. The cesarean section rate and the ratio of social factors in the senile group were higher than those in the non-senile group (67.08%[758/1 130] vs 48.51%[4 549/9 378], 42.88%[325/758] vs 10.07%[458/4 549], both P<0.01). The incidences of gestational diabetes mellitus, premature rupture of membrane, placenta praevia, placental implantation abnormality and postpartum hemorrhage of the senile group were significantly higher than those of the non-senile group (all P<0.05). The incidences of pregnancy-induced hypertension syndrome, pre-eclampsia, chronic hypertension complicating pregnancy of the senile group were significantly higher than those of the non-senile group (all P<0.05). The incidences of liver diseases, diseases of urinary system, abnormal thyroid function, thrombotic diseases and malignant tumor complicated with pregnancy were significantly higher in the senile group than those in the non-senile group (all P<0.05). For outcome of perinatal infants, the onset rates of asphyxia neonatorum, death of perinatal infants and premature infants were significantly higher in the senile group than those in the non-senile group (all P<0.05). Conclusion The risks of pregnancy complications and adverse pregnancy outcomes are increased in senile pregnant women. Appropriate-age pregnancy and perinatal care of senile pregnancy should be advocated in clinic.