This study attempted using a descriptive survey to elucidate the influence of anxiety and dyadic adjustment on maternal-fetal attachment in high-risk pregnant women. Methods: The data used in this study were collected from March 3 rd , 2015, to March 30 th , 2015, and the participants were 118 pregnant women including those undergoing prenatal tests and those admitted to a delivery room in the obstetrics outpatient center of 3 university hospitals located in B, D, and Y after diagnosis with high-risk pregnancy during 20-38 weeks of gestation. Collected data were analyzed using frequency, percentage, mean, standard deviation, t-test, ANOVA, Pearson's correlation, and stepwise regression analysis using the IBM SPSS 22.0 program. Results: The level of maternal-fetal attachment according to participants' general and obstetric characteristics showed significant differences in history of childbirth, prenatal tests, and planned pregnancy. The factors that influenced maternal-fetal attachment were history of childbirth, prenatal tests, anxiety, and dyadic adjustment. Lower anxiety and high dyadic adjustment of high-risk pregnant women led to a high maternal-fetal attachment. Among them, anxiety was the factor with the greatest impact, explaining 20.5%. Conclusion: This study presents the need for development and application of prenatal nursing intervention to enhance maternal-fetal attachment by lowering anxiety through prenatal care in high-risk pregnant women and improving dyadic adjustment.