Objective: To explore the best mode of delivery for pregnant women with scarred uterus who are pregnant again based on the policy of “full liberalization of second births”. Methods: A prospective study was conducted on 106 pregnant women with scarred uterus who were admitted to Department of Obstetrics and Gynecology, Chengfei Hospital from May 2017 to December 2018. The delivery mode was selected according to the maternal wishes and clinical indications. They were divided into a vaginal delivery group and a cesarean section group according to different delivery modes. We observed the delivery completion of the two groups, compared the amount of intrapartum hemorrhage and postpartum hemorrhage in the two groups, observed the occurrence of puerperal infection and neonatal asphyxia in the two groups, and statistics hospitalization time, hospitalization expenses, etc. Results: Among 106 pregnant women with scarred uterus, 38 received vaginal delivery. The success rate of vaginal delivery was 86.84% (33/38), and 5 were transferred to cesarean section. The amount of bleeding during delivery and 2 hours after delivery were less than those in the cesarean section group, with statistical significance (P<0.01); there was no significant difference in asphyxia in 5 minutes between the two groups (P>0.05); the infection rate, hospitalization time and hospitalization expenses in vaginal delivery group were lower than those in cesarean section group, with statistical significance (P<0.05). Conclusion: Pregnant women with scarred uterus with vaginal delivery indications should actively choose vaginal delivery. The success rate of trial delivery is high. It has significant effect on improving maternal and infant outcomes and saving hospitalization costs, and does not increase the risk of neonatal asphyxia.