Aim of the study: We aimed to compare the first, second and third trimester APRI (aspartate aminotransferase to platelet ratio index) scores in pregnant women with and without intrahepatic cholestasis (ICH). Material and methods: In this study, 54 patients diagnosed with ICH and 59 healthy pregnant women admitted to a tertiary care center between 2018 and 2024 were evaluated. APRI scores were compared between the two groups for three trimesters (first, second, and third trimester). The optimal cut-off values of the APRI score for the prediction of ICH were analyzed. Results: APRI scores were significantly higher in the ICH group in all trimesters (p = 0.028, p < 0.001, p < 0.001, respectively). The optimal cut-off value for APRI score to predict ICH in the first, second, and third trimesters was 0.06 (42.6% sensitivity, 83.1% specificity), 0.1 (57.4% sensitivity, 93.2% specificity) and 13 (77.8% sensitivity, 98.3% specificity), respectively. Conclusions: APRI score was found to be a significant predictor of ICH throughout the entire pregnancy. APRI score seems to be a useful marker in clinical practice to predict ICH.