Abstract: Objective To understand the knowledge of high-risk maternal management of grassroots medical staff,and to provide evidence for interventions to ensure maternal and child safety.Methods An examination paper on health management of high-risk pregnant women was designed to test 111 grass-roots medical staff in nine counties (cities and districts). The total score of the examination paper was 15 and the score was calculated and analyzed. Result The average score of 111 testers was (13. 08 ± 1. 28) points. There was no significant difference in scores between counties (F = 1. 903,P = 0. 067). There was no significant difference in the scores among different types units (F = 1. 334,P = 0. 267). The knowledge scores of territorial management,referral mode,reporting mechanism and evaluation summary of high-risk pregnant women were low.Conclusion The test results of knowledge highrisk maternal management among grass-roots medical staff are not optimistic. The training of knowledge of high-risk maternal management should be strengthened to ensure maternal and child health and safety.