Objective: To investigate the effect of intrauterine device (IUD) assisted transcervical resection of uterine adhesions (TCRA) on postoperative American Fertility Society (AFS) score, intrauterine morphology recovery and postoperative readhesion. Methods: From October 2020 to June 2021, A total of 82 patients with moderate to severe intrauterine adhesions (IUAs) admitted to Anqing Hospital of Traditional Chinese Medicine. According to the different treatment methods after TCRA, they were divided into two groups, 42 cases in the IUD group and 40 cases in the balloon catheter group. Both group was followed up for 6–12 months, and hysteroscopy was performed after 2 months after the operation. The AFS score, recovery of uterine cavity morphology, intrauterine readhesion rate and pregnancy rate were compared between the two groups. Results: Two months after operation, the AFS score of IUD group was significantly lower than that of balloon catheter group (P<0.05); the effective rate of menstrual recovery and uterine cavity morphology recovery was significantly higher than that of balloon catheter group (P<0.05). There was no significant difference in the incidence of readhesion between IUD group and the balloon catheter group (P>0.05). Patients were followed up for 6–12 months, there was no significant difference in the clinical pregnancy rate, biochemical pregnancy rate and ectopic pregnancy rate between the two groups after one year of follow-up (P>0.05). Conclusion: Compared with balloon catheter, IUD implantation after TCRA has better effect on AFS, menstruation and uterine cavity morphology, but it has no obvious advantages in preventing intrauterine readhesion and improving pregnancy rate.