This study aims to compare uterine activity in intrahepatic cholestasis of pregnancy (ICP) patients vs normal pregnancies, and to determine the relevance of ICP and excessive uterine activity. A total of 59 patients with ICP and 89 with normal pregnancies were selected. Liver function, total bile acids and uterine activity were evaluated; uterine contraction parameters were compared at the specified range of gestational age. Uterine contraction frequency was significantly higher in the third trimester patients with ICP. Aspartate transaminase (AST) appeared to correlate with contraction frequency (r = 0.357, p = 0.006) and Montevideo units (MVUs) (r = 0.349, p = 0.007). For each 50 U/l increase in AST, the hazard ratio of excessive uterine activity was increased by 1.31-fold (95% CI = 1.034-1.663, p = 0.025). The present study demonstrates that third trimester uterine contractility increases in patients with ICP. These findings should be of note, given what is known about obstetric cholestasis, and should prompt further research.