Objective: To explore the significance of color Doppler ultrasonography for guiding the choice of delivery mode of pregnancy again by detecting the healing of uterine scars and for guiding the evaluation of pregnancy outcomes. Methods: 128 pregnant women with a history of cesarean section were selected in observation group, and 128 pregnant women without cesarean section were selected in control group during the same time. The situation of uterine scar healing was evaluated by color Doppler ultrasonography. The thickness of the lower uterine segment, the mode of delivery, and the pregnancy outcomes of women were compared between two groups. Results: In the observation group, there were 93 (72.7%) women with homogeneous type uterine scar, 25 (19.5%) women with tail-shaped type uterine scar, and 10 (7.8%) women with truncation type uterine scar. The average thickness of the lower uterine segment of women in the observation group was 2.9±1.4 mm, which was significant lower than that(4.5±1.1 mm) of women in the control group, but the cesarean section rate of women in the observation group was 50.8%, which was significant higher than that (32.8%) of women in the control group (P<0.05). In the observation group, the average thickness of the lower uterine segment of women with uterine scar healing well was 3.6±1.1 mm, which was significant lower than that(2.1±1.2 mm) of women with poor uterine scar healing, but the cesarean section rate of women with uterine scar healing well was 35.5%, which was significant higher than that (91.4%) of women with poor uterine scar healing (P<0.05), and the incidence of neonatal asphyxia, incomplete uterine rupture, and postpartum hemorrhage in pregnant  women with uterine scar healing well were also significant lower than those of women with poor uterine scar healing (P<0.05). Conclusion: The poor uterine scar healing can increase the risks of uterine rupture, postpartum hemorrhage, and neonatal asphyxia. The healing of uterine scar of women during pregnancy is assessed by high-frequency color Doppler ultrasonography can guide the correct choice of delivery mode, which can reduce the risk of childbirth and ensure maternal and child safety.