Toxemia of pregnancy is a very dangerous disease for pregnant women. The mortality rate of toxemia of pregnancy is close to 10% to 15%. Early detection of pregnancy toxemia is to monitoring uric acid concentration in urine. The current mainstream method for detecting uric acid requires an enzyme (urate oxidase), which needs to be stored in a low-temperature environment, and the method requires complex chemical steps, which takes a longer time and more samples. In this study, we propose an integrated miniature three-electrode electrochemical surface-enhanced Raman spectroscopy chip (EC-SERS chip) suitable for rapid EC-SERS detection applications. The integrated microfluidic reservoir on the chip makes it easy to use, which is very suitable for rapid detection applications. The SERS active working electrode for the proposed integrated EC-SERS chip is a nanocone array polycarbonate (PC) substrate decorated with an evenly distributed and tightly packed array of gold nanospheres. It showed good uniformity and can be easily reproduced. The integrated EC-SERS chip is very small compared to the traditional electrochemical cell, which reduces the sample volume required for the testing. In addition, the chip is for one-time use only. It eliminates the need to clean electrochemical cells for reuse, thereby reducing the possibility of contamination and inaccurate detection. Various low-concentration Rhodamine 6G (R6G) solutions were tested to verify the performance of the developed EC-SERS chip. Experimental results showed that the proposed EC-SERS chip has a strong enhancement factor of up to 8.5 × 106 and a very good EC-SERS uniformity (the relative standard deviation of EC-SERS intensity is as low as 1.41%). The EC-SERS chip developed has been further tested for the detection of uric acid in synthetic urine. The results showed that the EC-SERS signal intensity has a highly linear relationship with the logarithm of the uric acid concentration in synthetic urine, which indicates that the developed EC-SERS chip is suitable for the quantitative detection of uric acid in synthetic urine. Therefore, the developed EC-SERS chip is very promising to be used in routine and early diagnosis of pregnancy toxemia and may be used in many other medical tests, food safety, and biotechnology applications.