Objective To investigate the effect of residual amniotic fluid volume on the levels of inflammatory factors and perinatal outcome in preterm premature rupture of membranes (PPROM).Methods A total of 160 cases of PPROM patients were divided into control group (110 cases, AFI > 50 mm) and research group (50 cases, AFI ≤ 50 mm) according to amniotic fluid index (AFI). The two groups were given the same treatments. The delivery, pregnancy outcome, the health status of the newborn, and maternal levels of inflammatory factors were compared between two groups.Results The neonatal Apgar score and the proportion of vaginal delivery were in research group lower than those in control group (P < 0.05), while the incidence of endometritis, puerperal infection, chorioamnionitis, amniotic fluid pollution, fetal distress, neonatal asphyxia, low birth weight infant and neonatal respiratory distress syndrome in research group was higher than that in control group (P < 0.05). The maternal levels of serum β-hCG, PCT, CRP, TNF-α and IL-6 in research group were higher than those in control group (P < 0.05).Conclusions The low residual amniotic fluid volume has adverse effects on delivery and maternal and fetal outcomes in PPROM and it will increase the levels of inflammatory response. Therefore, the residual amniotic fluid volume should be closely monitored to ensure the safety of delivery.