Objective: To explore the relationship between the thickening of nuchal translucency (NT) and the pregnancy outcome of elderly pregnant women with fetal structural malformation and abnormal chromosome karyotype. Methods: The clinical data of perinatal demographic characteristics, incidence of fetal malformations, types of malformations, chromosome karyotypes and pregnancy outcomes of 279 pregnant women who underwent NT examination in our hospital from 2017 to 2020 were retrospectively analyzed to compare the correlation between fetal structural abnormalities, chromosome karyotype abnormalities and fetal NT thickening in the pregnancy outcome of advanced-age and normal-age pregnant women. Results: The results of this study showed that in 97 pregnant women with normal NT 2.5 mm, there were 80 cases of smooth outcome, 17 cases of unsmooth outcome, 2 cases of fetal structural malformation, 3 cases of chromosome abnormality, 84 cases of normal age group, 71 cases of smooth outcome, 13 cases of unsmooth outcome, 0 cases of fetal structural malformation and 0 cases of chromosome abnormality. Among the 49 pregnant women with NT thickening, there were 31 cases of smooth pregnancy, 18 cases of unsmooth pregnancy, 11 cases of fetal structural malformation, 11 cases of chromosome abnormality, 49 cases of normal age group, 36 cases of smooth pregnancy, 13 cases of unsmooth pregnancy, 5 cases of fetal structural malformation and 5 cases of chromosome abnormality. The results of pregnancy outcomes, fetal structural malformations and chromosomal karyotype abnormalities were compared between NT thickening and normal in elderly and normal pregnant women, there were statistically significant differences between the two groups (all P<0.05). Conclusion: The thickening of NT was negatively correlated with the pregnancy outcome, fetal structural abnormalities and chromosome karyotype abnormalities between the elderly and normal pregnant women, and the effect was more obvious in the elderly pregnant women.