Cystatin C (Cys-C) is emerging as a critical biomarker for assess gestational diabetes mellitus (GDM), a condition that significantly impacts maternal and fetal health. In this study, we developed a novel label-free electrochemical immunosensor designed for point-of-care applications, offering lower reagent consumption and rapid detection of Cys-C in pregnant women with GDM. Compared to traditional enzyme-linked immunosorbent assays (ELISA), the sensor demonstrates enhanced sensitivity, reduced reagent usage, and faster detection. In a cohort study involving 150 pregnant women with GDM and 150 healthy controls, serum Cys-C levels were analyzed using the developed sensor. Serum samples were collected and analyzed for Cys-C levels using our immunosensor. Serum Cys-C levels were significantly elevated in GDM patients compared to controls (P < 0.05), and higher levels were observed in GDM complicated by pregnancy-induced hypertension (PIH) and fetal growth restriction (FGR). Furthermore, elevated Cys-C levels were positively correlated with adverse pregnancy outcomes, including premature birth, fetal distress, and cesarean section (P < 0.05). This study underscores the potential of Cys-C as a reliable biomarker for GDM and highlights the advantages of our novel sensor for quick, accurate, and scalable GDM diagnosis and management.