Background <p>Pregnancy-associated listeriosis caused by foodborne infections poses a significant threat to maternal and neonatal health, with a high mortality rates. There is limited data on epidemiology of pregnancy-associated listeriosis in southeastern China (Xiamen), and we will report it in this study.</p> Methods <p>A retrospective analysis was conducted on confirmed cases of pregnancy-associated listeriosis in Xiamen from 2015 to 2023. Patient data was extracted from the hospital’s electronic medical records. Data analysis and epidemiological investigations were performed based on demographic information, onset time, clinical and laboratory characteristics. Antibacterial susceptibility testing was conducted on isolated <i>Listeria monocytogenes (LM)</i> strains using the broth microdilution method.</p> Results <p>In Xiamen, pregnancy-associated listeriosis incidence over 9 years was 7.15/100,000 (9/125,816) deliveries, with sporadic cases. Predominant symptoms among pregnant women included fever (88.9%), abdominal pain (66.7%), decreased fetal movement (66.7%), fetal tachycardia (66.7%), and flu-like symptoms (55.6%). Elevated neutrophil percentages (NE%), C-reactive protein (CRP), and procalcitonin (PCT) were observed in all pregnant women. Placental pathology consistently showed acute chorioamnionitis and micro-abscesses. Although all pregnant women recovered, out of 10 offspring, only 5 survived birth, and merely 3 were eventually cured, resulting in a feto-neonatal mortality rate of 70.0% (7/10). All <i>LM</i> strains showed susceptibility to ampicillin, penicillin, meropenem, erythromycin, and trimethoprim-sulfamethoxazole (SXT).</p> Conclusions <p>Although pregnancy-associated listeriosis is rare in Xiamen, it can have catastrophic effects on fetuses. Its atypical clinical features require timely testing in cases of inflammation and infection signs, stressing the significance of prevention awareness and prompt medical intervention.</p>