Objective: To analyze the clinical situation of pregnancy with pyelonephritis. Methods: Sixty-eight pregnant women with pyelonephritis during pregnancy were included in the Outpatient Clinic of Tongzhou Maternal and Child Health Hospital from January 2018 to September 2019. Their clinical symptoms were analyzed. Routine blood and urine tests, urine bacterial culture, types and proportion of pathogenic bacteria were carried out, and drug sensitivity tests were carried out with commonly used antibiotics. Results: The main symptoms of pregnancy patients with pyelonephritis were fever, headache and shiver, and most of them were accompanied with frequent urination, nausea and vomiting. Among the 68 pregnant women, 53 had anemia, accounting for 77.94%, and 59 had high urine leukocyte value, accounting for 86.76%. A total of 49 pathogenic bacteria were isolated, especially Escherichia coli. The results of drug sensitivity showed that it was sensitive to cephalosporins and had low drug resistance, while it was resistant to ampicillin, levofloxacin and other drugs. Conclusion: During the actual treatment of pregnant women with pyelonephritis, we should combine the results of strain culture and drug sensitivity results to select the antibiotics reasonably, so as to improve the treatment effect.