Objective To explore the effect and safety of three-dimensional after loading precision radiotherapy combined with external intensity-modulated radiation in the treatment of cervical cancer. Methods A retrospective analysis was performed on the data of 84 patients with cervical cancer admitted to the hospital from April 2018 to April 2021. All underwent three-dimensional after loading precision radiotherapy. After that, those who underwent external intensity-modulated radiation and routine radiotherapy were included into study group (n=44) and control group (n=40), respectively. The curative effect, tumor markers and quality of life before and after treatment, drug side effects and 1-year recurrence-free survival rate were compared between the two groups. Results The remission rate in study group was higher than that in control group (95.45% vs 77.50%, P<0.05). After treatment, levels of tumor markers ［cytokeratin 19 fragment antigen 21-1 (CYFRA21-1), squamous cell carcinoma (SCC) antigen, tumor-specific growth factor (TSGF)］ in both groups were significantly decreased (P<0.05),which were lower in study group than control group(P<0.05). After treatment, Karnofsky scores in both groups were significantly increased (P<0.05), which were higher in study group than control group(P<0.05). The incidence of drug side effects (radiation cystitis, gastrointestinal reactions, radiation proctitis, liver damage, bone marrow suppression) in study group was significantly lower than that in control group (P<0.05). The differences in 1-year recurrence-free survival rate between study group and control group were statistically significant (95.5% vs75.0%) (χ2=6.797, P<0.001).Conclusion Effect and safety of three-dimensional after loading precision radiotherapy combined with external intensity-modulated radiation are excellent in the treatment of cervical cancer