Abstract: Objective: To explore the level of pregnancy stress and its influencing factors among didymous elderly pregnant women. Methods: Totally 168 didymous elderly pregnant women who took part in the antenatal examination were recruited and investigated using 36-item Pregnancy Stress Rating Scale, Perceived Social Support Scale, Simplified Coping Style Questionnaire, and demographic questionnaire. Results: The mean scores of pregnancy stress, perceived social support, positive coping, and negative coping were 50.54±16.92, 69.68±9.05, 1.88±0.50, and 1.10±0.48, respectively. Dimensions of perceived social support and positive coping were significantly negatively correlated with pregnancy stress. Negative coping was positively correlated with pregnancy stress. Pregnancy complications, negative coping, and perceived social support could explain 55.1% of the pregnancy stress variance. Conclusion: Didymous elderly pregnant women were at a moderate level of pregnancy pressure. Nurses should vigorously strengthen prenatal education and provide targeted nursing and guidance for didymous elderly pregnant women to reduce their pregant pressure and help them get through pregnancy and childbirth stages.