Objective To investigate the incidence of failed conversion of epidural labor analgesia to cesarean delivery anesthesia and related factors. Methods A total of 1 143 pregnant women who underwent epidural labor analgesia in the First Affiliated Hospital of Xinjiang Medical University from January to November 2019 were retrospectively included. After conversion to cesarean delivery, 3 ml of 1% lidocaine was given as a test dose in epidural space, and 7 ml of 1% ropivacaine was given after observation for 5 min. If ropivacaine did not exert effects 20 min after administration, it was considered as epidural anesthesia failure, and general anesthesia was used for remedy. Then, the following data were collected: weight, height, parity, American Society of Anesthesiologists (ASA) grade, dilatation of uterine orifice at the beginning of epidural analgesia, Visual Analogue Scale (VAS) score, the qualification of anesthesiologists, the details of intraspinal block, the duration of intraspinal labor analgesia, the times of single drug‑addition through epidural catheter when pain broke out, and neonatal weight. The related factors of epidural anesthesia failure were analyzed by Logistic regression. The area of receiver operating characteristic (ROC) curve was used to fit the effects. Results There were 243 pregnant women who were transferred to cesarean delivery after vaginal delivery failure, with a transfer rate of 21.3%, and 81 (33.3%) of them showed epidural anesthesia failure. There were statistical differences in the effects of the number of pain outbreaks and the duration of epidural labor analgesia for more than 6 h on epidural anesthesia (P<0.05). Logistic regression analysis showed that, the odds ratio (OR) was 0.536 for the duration of epidural labor analgesia for more than 6 h. The prediction results of the current model showed that the ROC area under curve (AUC) was 0.789. Compared with the random model with AUC of 0.5, the prediction effect of the current model was significantly better than that of the random model (P<0.05). Conclusions The failed conversion of epidural labor analgesia to cesarean delivery anesthesia is related to the duration of analgesia and poor analgesia effect when pregnant women actively increase drug doses, which provides clinical evidence for future studies.