Purpose: This study analyzed the associations between spouses’ stress related to the hospitalization of high-risk pregnant (HRP) women and paternal-fetal attachment (PFA). Methods: We recruited 113 spouses of HRP women who had been hospitalized in the maternal-fetal intensive care unit in two tertiary hospitals. Data were collected from May 10 to December 23, 2019 using a 35-item questionnaire, which measured the spouses’ stress related to the hospitalization of their HRP wife, and the Korean version of the PFA scale. Results: Spouses’ stress related to the hospitalization of HRP women showed a score of 1.92±0.42 out of 4, and “emotional problems” had the highest score among the subcategories. PFA showed a score of 4.31±0.52 out of 5, and “parental behavioral change” had the lowest score among the subcategories. A significant negative correlation was found between spouses’ stress related to the hospitalization of their HRP wife and PFA. Among the subcategories of spouses’ stress, communication and support resources (r=-.39, p<.001), hospital environment (r=-.33, p<.001), emotional problems (r=-.27, p= .004), and family life and financial problems (r=-.21, p=.026) showed significantly negative correlations, while illness, prognosis, and the treatment showed no correlations. Conclusion: To reduce spouses’ stress related to the hospitalization of HRP women, they should be guided on carrying out direct interactive activities with the fetus from conception and throughout the pregnancy to strengthen PFA. Furthermore, regarding illness, prognosis, and treatment, accurate and detailed explanations should be provided to the spouses by the medical staff.