ObjectiveTo investigate the effectiveness of different drug use regimens in preventing the development of preeclampsia in high-risk pregnant women in China. MethodsWe searched CNKI, Wanfang, VIP, Pubmed, Embase, and Cochrane library databases. Randomized controlled trials (RCTs) of published studies on the prevention of the onset of preeclampsia in high-risk pregnant women in China were searched between January 2000 and August 2024. After two investigators independently screened the literature according to the inclusion and exclusion criteria, extracted the data, and evaluated the included studies, a reticulated meta-analysis was performed using Stata 15.0 software. ResultsA total of 33 randomized controlled studies with 5 364 patients involving five pharmacological intervention regimens were included. Network meta-analysis showed that aspirin combined with vitamins and aspirin combined with calcium were more effective than aspirin alone up to 36 weeks in preventing the onset of preeclampsia. The results of the best probability ranking showed that aspirin combined with vitamins and aspirin combined with calcium had a higher probability of being optimal for preventing the onset of preeclampsia. ConclusionAspirin is effective in preventing the development of preeclampsia in high-risk pregnant women in China, but it is necessary to develop an individual combination management plan according to the patient's specific situation.