Key pointsr Chronic hypoxia has a direct effect in down-regulating the BK Ca channel β1 subunit and inhibiting the BK Ca channel activity in uterine arteries of pregnant sheep.r Oxidative stress plays a causal role in hypoxia-mediated suppression of BK Ca channel function. r The steroid hormone-induced effect on BK Ca channels is a target of hypoxia-mediated oxidative stress.r Inhibition of oxidative stress ameliorates the adverse effect of hypoxia both ex vivo and in vivo in pregnant sheep exposed to long-term high-altitude hypoxia.r Our findings provide novel evidence of a causative role of oxidative stress in hypoxia-mediated inhibition of the BK Ca channel activity in uterine arteries and new insights in understanding and alleviating pregnancy complications associated with gestational hypoxia such as pre-eclampsia and fetal growth restriction.Abstract Uterine arteries of pregnant sheep acclimatized to long-term high-altitude hypoxia were associated with a decrease in large-conductance Ca 2+ -activated K + (BK Ca ) channel activity. The present study tested the hypothesis that prolonged hypoxia has a direct effect in suppressing BK Ca channel activity by increasing oxidative stress. Uterine arteries were isolated from non-pregnant and near-term (ß142 days) pregnant sheep, and were treated ex vivo with 21.0 or 10.5% O 2 for 48 h. The hypoxia treatment significantly increased the production of reactive oxygen species in uterine arteries, which was blocked by N-acetylcysteine. In uterine arteries of pregnant sheep, hypoxia significantly inhibited BK Ca channel current density, decreased NS1619-induced relaxations and increased pressure-dependent tone, which were annulled by N-acetylcysteine. In accordance, hypoxia resulted in down-regulation of BK Ca channel β1 subunit, which was restored in the presence of N-acetylcysteine. In addition, the N-acetylcysteine treatment significantly increased BK Ca channel β1 subunit abundance and BK Ca channel current density in uterine arteries from pregnant sheep exposed to high-altitude hypoxia (3801 m, P aO 2 : 60 mmHg) for 110 days. In uterine arteries of non-pregnant animals, hypoxia inhibited steroid hormone-induced up-regulation of BK Ca channel current density and NS1619-mediated relaxations, which were reversed by N-acetylcysteine. Furthermore, the synthetic superoxide dismutase and catalase mimetic EUK-134 also ablated the effects of hypoxia on BK Ca channel currents in uterine arteries. The results demonstrate a direct effect of hypoxia in inhibiting the BK Ca channel activity in uterine arteries via increased oxidative stress.