To explore the influence factors of the vaginal trial delivery transferred to cesarean of women and the pregnancy outcomes of the women. Methods: The clinical data of 500 pregnant women with scar uterine who had delivery from October 2018 to October 2021 were analyzed retrospectively. Among them, 228 women had vaginal trial births, including 162 cases with successful vaginal trial births in group A, and 66 cases with failed vaginal trial births in group B. The clinical data of the women in the two groups were analyzed. Logistic regression analysis was used to analyze the influence factors of vaginal trial delivery transferred to cesarean and the pregnancy outcomes of the women. Results: Univariate analysis showed that there were significant differences in the age, the body mass index(BMI), the neonatal weight, the time from the scar uterus occurrence to pregnancy, the number of pregnancy fetuses, the fetal malposition, the fetal distress, the pregnancy complications, and the labor stagnation of the women between the two groups(P＜0.05). Multivariate logistic regression analysis showed that the time from scar uterus occurrence to pregnancy <3 years, the fetal malposition, the fetal distress, the pregnancy complications, and the labor stagnation of the women were the risk factors of their vaginal trial delivery transferred to cesarean, and the maternal age <35 years old, the maternal BMI <26kg/m2, the neonatal weight <3500g, and the singleton pregnancy of the women were the protective factors of their vaginal trial delivery transferred to cesarean(all P＜0.05). The puerperal infection rate(3.7%) and the neonatal birth weight(3032.5±73.3g) of the women in group B were significantly lower than those(10.4%,173.3±81.1g) of the women in group A. The Apgar score(9.4±0.5 points) of the newborns at 1min after birth in group B was significantly higher than that(8.4±0.7 points) of the newborns in group A(all P＜0.05). There were no significant differences in the situations of the fetal distress, the uterine rupture, the postpartum hemorrhage, and the neonatal asphyxia of the women between the two groups(P＞0.05). Conclusion: The maternal factors and the neonatal factors are all the influencing factors of the vaginal trial delivery transferred to cesarean of the pregnant women with scarred uterus. The vaginal trial delivery of the women will not increase their complications, such as fetal distress, uterine rupture, and postpartum hemorrhage. The indications for vaginal trial delivery should be strictly controlled, so as to increase the rate of vaginal delivery and reduce the rate of cesarean section in clinic.