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Objectives This study assessed the knowledge, attitude and practice (KAP) of pregnant women in Chongqing, China, regarding pre-eclampsia and examined their inter-relationships.Design A cross-sectional survey was conducted using validated questionnaires.Setting The study was conducted between May 2023 and August 2023 in Chongqing, China.Participants A total of 427 pregnant women were included, with 68.15% aged ≤30 years and a mean pregnancy duration of 238.18±45.01 days.Interventions This was an observational study, and interventions were applied.Primary and secondary outcome measures The primary outcomes were the KAP scores (knowledge: 0–40; attitude: 12–60 and practice: 10–50). The correlations and structural equation modelling (SEM) analyses were conducted to explore the relationships among KAP.Results Mean scores were 22.19±12.17 (knowledge), 46.38±6.14 (attitude) and 41.96±5.96 (practice). Knowledge positively correlated with attitude (r=0.586, p<0.001) and practice (r=0.387, p<0.001). Attitude correlated with practice (r=0.593, p<0.001). SEM showed knowledge directly influenced attitude (β=0.716, p<0.001), while attitude directly affected practice (β=0.444, p<0.001). Knowledge indirectly impacted practice via attitude (β=0.151, p=0.001).Conclusions Pregnant women exhibited inadequate knowledge and a suboptimal attitude but a proactive practice. Targeted interventions to improve knowledge and attitudes are recommended for better clinical outcomes, particularly in regions where few such studies have been conducted.