Objective: The aim of this study was to discuss the effects of alimentary control and nutrition guidance on blood glucose and pregnancy outcomes in patients with gestational diabetes mellitus. Methods: Between January 2014 and December 2017, 100 pregnant women with gestational diabetes and with 24-28 weeks of gestational age were enrolled. They were equally randomized into two groups receiving either conventional dietary education (control group, n = 50) or individualized alimentary control and nutrition guidance (observation group, n = 50). Rates of blood glucose control abnormality, fasting blood glucose (FBG), and two-hour postprandial blood glucose were compared between the two groups after 3 months of intervention. Pregnancy complications (intrauterine infection, premature rupture of membrane, postpartum hemorrhage, and polyhydramnios) and perinatal complications (neonatal asphyxia, fetal distress, premature delivery, and infant mortality rate) were also compared. Results: After intervention, rates of blood glucose control abnormality, FBG, and two-hour postprandial blood glucose were significantly lower in the observation group than in the control group (all P < 0.001), as well rates of pregnancy complications and perinatal complications (all P < 0.001). Conclusion: Alimentary control and nutrition guidance are beneficial in controlling blood glucose and improving pregnancy outcomes of women with gestational diabetes. It is, therefore, worthy of popularization.