To investigate the effect of alfentanil combined with propofol used in intrauterine device(IUD) removal of postmenopausal women on the degree of their cervical softening and the success rate of their. Method: 100 postmenopausal women who wanted IUD removal were randomly divided into group A and group B from January 2021 to March 2023. 50 women in group A received alfentanil combined with propofol for anesthesia during surgery, while 50 women in group B received fentanyl combined with propofol for anesthesia. The changes of vital signs, the stress response, the degree of cervical softening, the success rate of IUD removal, and the complications, such as pain, uterine bleeding, endometrial damage, and infection, of the women in both groups were observed. Results: The average arterial pressure and decreasing heart rate of the women in both groups during surgery and immediately after surgery had decreased significantly, and which of the women in group A were significantly higher than those of the women in group B. The levels of postoperative cortisol and norepinephrine increased of the women in both groups had increased significantly, and which of the women in group A were lower significantly than those of the women in group B. The rate of cervical complete softening(90.0%) of the women in group A was significantly higher than that(74.0%) of the women in group B, the success rate(100.0%) of IUD removal of the women in group A was significantly higher than that(92.0%) of the women in group B, and the incidence of complications(2.0%) of the women in group A was significantly lower than that(14.0%) of the women in group B(all P<0.05). Conclusion: Alfentanil combined with propofol used in IUD removal of the postmenopausal women has good effect, which can stabilize the vital signs, reduce the stress reactions, improve the cervical softening degree, increase the success rate of IUD removal, and reduce the complications of the women.