〔Abstract〕 Objective To study the clinical effect of the scar pruning of lower uterine in the second cesarean section of the scarred uterus. Methods From April 2019 to October 2020, 50 parturient with scarred uterus who underwent secondary cesarean section in the obstetrics department of Yingde City Hospital of Traditional Chinese Medicine were selected and grouped by random number table, 25 cases in the control group and 25 cases in the observation group. The control group underwent conventional cesarean section operation, and the observation group added lower uterine scar trimming during the conventional cesarean section operation. The effects of the two surgical methods on surgical indicators, maternal and infant outcomes, and postoperative diverticulum formation were compared. Results There was no significant difference in the operation time between the two groups of parturients (P > 0.05), but comparing the intraoperative blood loss of the two groups of parturients, it was found that the observation group had less blood loss. The postoperative anal exhaust time and hospital stay of the observation group were shorter than those of the control group (P < 0.05). The incidence of abnormal uterine bleeding, dysmenorrhea and chronic pelvic pain in the observation group 42 days and 9 months postpartum were lower than those of the control group, and the rate of diverticulum formation was significantly lower than that of the control group (P < 0.05). After comparing the incidence of asphyxia, Apgar score, and body weight of the two groups of newborns, the result was found that the difference was not statistically significant (P > 0.05). Conclusion Scar uterus trimming of the lower uterine scar during the second cesarean section can effectively prevent the formation of diverticulum in the postoperative uterine incision, reduce the amount of intraoperative bleeding, reduce the risk of postpartum hemorrhage, and help shorten the postoperative recovery time improve clinial symptoms.