Purpose of investigation: The authors investigated the difference between the first-trimester maternal serum markers of intrahepatic cholestasis of pregnancy (ICP) cases and uneventful pregnancies, which might be useful in disease prediction. Materials and Methods: Twenty patients who had ICP and 40 pregnant women as control group were enrolled and the first-trimester maternal serum markers, maternal and fetal outcomes were compared between two groups. First trimester maternal serum markers: pregnancy-associated plasma protein A (PAPP-A) and free beta-human chorionic gonadotropin (β-hCG) are the essential components of aneuploidy screening and prediction of adverse obstetric outcome. Results: Serum PAPP-A and free β-hCG levels were significantly higher in the ICP group. The mean serum PAPP-A was significantly higher in the ICP than control groups (2.4 ± 0.9 MoM vs. 1.2 ± 0.3 MoM: p < 0.001, respectively) and the mean of serum free β-hCG was significantly higher in the ICP than control groups (1.8 ± 1.5 MoM vs. 1.2 ± 0.6 MoM; p = 0.036, respectively). Gestational week at birth and the birth weights were lower in the ICP group (p < 0.001 and p = 0.005, respectively). Conclusion: The first-trimester maternal serum markers were elevated in case of ICP and this might be useful in disease prediction.