Objective To investigate the effect of dexmedetomidine (DEX) combined with transversus abdominis plane block (TAPB) on analgesia and gastrointestinal function in women with scarred uterus after cesarean section.Methods A total of 105 pregnant women with scarred uterus who underwent elective cesarean section in our hospital from October 2020 to December 2021 were selected as the research subjects, and the above-mentioned women were divided into a study group of 50 cases and a block randomization method using a random number table. 55 cases in the control group, both groups underwent cesarean section under spinal anesthesia. After the neonates were excised, the study group was pumped with DEX 0.5 μg/kg, and the control group was pumped with the same amount of normal saline, both of which were pumped for 10 minutes. Bilateral TAPB (20ml of 0.375% ropiper on both sides) was given, and patient-controlled intravenous analgesia (PCIA) was used after operation. The BCS comfort score, the number of PCIA compressions, the recovery time of bowel sounds, the first anal exhaust time, the first time to get out of bed, and the occurrence of adverse reactions were recorded. Results VAS score and BCS comfort score at 4 h and 48 h after surgery were not significantly different between the two groups (P> 0.05). VAS scores of the study group at 8 h, 12 h and 24 h after surgery were lower than those of the control group, and BCS comfort scores were higher than those of the control group (P< 0.05). The cumulative times of analgesic pump compression at 8 h, 12 h, 24 h and 48 h of the study group were lower than those of the control group (P< 0.05), and the recovery time of bowel sound, the first time of anal discharge and the first time of getting out of bed were shorter in the study group than those in the control group (P< 0.05). There was no significant difference in adverse reactions between the two groups (P> 0.05). Conclusion Dexmedetomidine combined with transversus abdominis plane block has a significant analgesic effect after cesarean section for women with scarred uterus, and is helpful for the recovery of postoperative gastrointestinal function. It is safe and suitable for promotion.