BACKGROUND Urinary tract infections (UTIs) are common during pregnancy and can negatively impact maternal and neonatal health. Hypertension in pregnancy is a leading cause of maternal morbidity. UTIs can contribute to hypertension development through mechanisms like inflammation, leading to endothelial dysfunction and impaired placental development. This study aimed to evaluate the association between bacteriuria and hypertension in pregnant women. MATERIAL AND METHODS This multicenter study was conducted at 2 hospitals in Indonesia from 2022 to 2023, including 742 pregnant women who met the inclusion criteria. The women were grouped based on bacteriuria and hypertension status. The bacteriuria-positive group had 322 women, of which 125 had hypertension. The bacteriuria-negative group included 421 women, with 101 having hypertension. Statistical analysis was performed to determine the odds ratio (OR) and prevalence ratio. RESULTS Women with bacteriuria were twice as likely to develop hypertension compared to those without (OR=2.01, 95% CI: 1.47-2.76, P<0.001). In the hypertensive group, 55.3% had bacteriuria compared to 38.1% in the normotensive group. Conversely, women without bacteriuria had a reduced likelihood of developing hypertension (OR=0.5, 95% CI: 0.38-1.02, P<0.001). CONCLUSIONS This study highlights a significant association between bacteriuria and increased hypertension risk in pregnancy. Given that bacteriuria is routinely screened for, it can be a valuable tool for identifying women at higher risk of hypertensive disorders. Monitoring bacteriuria-positive women is recommended to help manage and potentially prevent hypertensive complications during pregnancy.