Aim: To compare the maternal-fetal outcomes in Chinese urban women at the maternal age of ≥ 40 years with those aged between 35 and 39 years. Materials and Methods: In this retrospective study, women in a single-center that delivered from January 1 to December 31, 2013, were included. The authors divided the subjects into two groups according to the age, and evaluated the obstetric history, delivery mode, incidence of obstetric diseases, and neonatal outcomes of each group. Results: They enrolled 1,965 pregnant women in total. The women between 35 to 39 years of age reached 1,727 (87.9%), and the remaining 238 (12.1%) were women ≥ 40-years-old. The incidence rates of in vitro fertilization (IVF, p < 0.01), gestational diabetes mellitus (GDM) (p < 0.05), and hypertension (p < 0.05) for the elder group were higher than the younger group. Furthermore, women ≥ 40-years-old were associated with a higher rate of cesarean section (84.0% vs. 67.6%, p < 0.001) compared with the younger group, varying significantly on intrauterine infection (1.5% vs. 0.5%, p < 0.05), IVF (6.5% vs. 3.2%, p < 0.01), and maternal request (41.0% vs. 30.6%, p < 0.001). No significant differences in neonatal outcomes were found and no neonatal deaths were recorded for the two groups. Conclusions: These results showed an increase risk of pregnancy complications for the women giving birth at ≥ 40 years of age, yet most of them still carried a favorable pregnancy and neonatal outcome, similar to the younger women.