To investigate the r elative factors between the degree of adhesion in secondary cesarean section and the first cesarean section. Methods: The clinical data of 517 women undergone secondary cesarean section between October 2017 and October 2019 were analyzed retrospectively. According to the situation of pelvic and abdominal adhesions found during the secondary cesarean section, these women were divided into 240 women in group A (240 women without adhesion), group B (111 women with mild adhesion), group C (126 women with moderate adhesion), and group D (40 women with severe adhesion). Univariate analysis, multivariate Logistic analysis and Spearman rank correlation analysis were used to investigate the influence factors of the first cesarean section on the degree of pelvic and abdominal adhesions found during the second cesarean section. Results: The proportion of different degree of pelvic and abdominal adhesions found during the second cesarean section of women within 2 years from the first cesarean section, women with multiple pregnancy when last pregnancy, women with abdominal wall transverse incision when the first cesarean section, women with amniotic fluid contamination when last pregnancy, women with uterine incision tear and unsutured peritoneum when the first cesarean section had increased significantly (P<0.05). The interval between the twice cesarean section was negatively correlated with the degree of pelvic and abdominal adhesions found during the second cesarean section (r=-0.339, P<0.001). The degree of amniotic fluid contamination found during the first cesarean section was positively correlated with the degree of pelvic and abdominal adhesions (r=0.487, P<0.001). During the first cesarean section, amniotic fluid contamination found (β=1.139, OR=3.124, 95% CI=1.715-5.690), uterine incision tear (β=0.853, OR=2.347, 95%CI=1.189-4.633), and unsutured peritoneum (β=0.373, OR=1.459, 95%CI=1.151-1.850) were risk factors of pelvic and abdominal adhesions found in the second cesarean section. Conclusion: To reduce postoperative pelvic and abdominal adhesions, abdominal wall longitudinal incision is better, the peritoneum of women should be sutured, amniotic fluid contamination and uterine incision tear should be avoided when women undergoing cesarean section.