Objective To analyze the causes，clinical features and common risk factors of complete uterine rupture and to reduce the impact of uterine rupture on maternal and fetal outcomes. Methods A total of 136 patients with complete uterine rupture in late pregnancy from various regions of Henan Province between January 2016 and August 2023 were retrospectively analyzed for the causes of rupture，clinical characteristics，risk factors，and maternal and infant outcomes. Results （1）The causes of uterine rupture were mainly scarred uterus after cesarean section and history of uterine operation，which accounted for 79.41% and 13.24%，respectively.（2） The main symptoms of uterine rupture were abdominal pain，abnormal fetal heartbeat，and vaginal bleeding，among which the incidence of abdominal pain was 77.94%，fetal heartbeat abnormality was 34.56%，and vaginal bleeding accounted for 21.32%.（3） Maternal and fetal outcome：136 cases of uterine rupture，83 cases had a good outcome，53 cases had an adverse pregnancy outcome，and the incidence of postpartum hemorrhage was 32.35%，of which the incidence of massive blood transfusion was 29 cases（21.32%），and hysterectomy was 14 cases，with an incidence of 10.29%. There were 0 maternal deaths. Maternal adverse pregnancy outcomes were associated with gravidity（OR=2.13，95% CI 1.08-4.20，P=0.029），and the length of uterine rupture （OR=1.21，95% CI 1.09-1.34，P<0.001），and the site of uterine rupture （OR=4.19，95% CI 1.32-13.29，P=0.015）.（4） perinatal outcomes：133 cases of perinatal cases were included in this study，74 cases of adverse pregnancy outcomes，preterm labor 42 cases，34 cases of neonatal asphyxia，11 cases of intrauterine fetal death，13 cases of neonatal death，and the perinatal mortality rate was 18.05%. Adverse perinatal outcomes were associated with gestational week（OR=0.51，95%CI 0.36-0.70，P<0.001），and length of uterine rupture （OR=1.16，95% CI 1.04-1.33，P=0.031），and abnormal fetal cardiac monitoring （OR=7.16，95% CI 1.88-27.32，P=0.004）. Conclusions In those with keloid uterus re-pregnancy，symptoms of persistent abdominal pain in late pregnancy and abnormal fetal heartbeat and vaginal bleeding during labor should be alerted to the possibility of uterine rupture. Scarred uterus is a major risk factor for uterine rupture. Length of uterine rupture is a risk factor for adverse maternal outcomes. Length of uterine rupture and abnormal fetal cardiac monitoring are risk factors for adverse perinatal outcomes.