Objective To investigate the effect of intrathecal analgesia on the success rate and adverse reactions of external cephalic version (ECV) in women with breech pregnancy. Methods A total of 90 women with singleton breech pregnancy were selected. According to the random number table method, they were divided into three groups (n=30): a control group (group C) which did not receive analgesia during ECV, an epidural analgesia group (group EA) which underwent epidural block for analgesia during ECV, and a combined spinal‑epidural analgesia (CSEA) group which received combined spinal‑epidural block for analgesia during ECV. Their Visual Analogue Scale (VAS) scores during ECV, satisfaction score for pain relief, ECV success rate (instantaneous success rate and overall success rate), transfer cesarean section rate, maternal and fetal adverse reactions were recorded. Results Compared with group C, group EA and group CSEA showed decreased VAS scores during ECV (P<0.05), and increased satisfaction scores for pain relief (P<0.05). There was no statistical difference in VAS score and satisfaction score between group EA and group CSEA during ECT (P>0.05). The instantaneous success rate and overall success rate of ECV in group EA and group CSEA were higher than those in the group C (P<0.05), while the rate of transfer to cesarean section was lower than that in group C (P<0.05). There were no statistical differences in instantaneous success rate, overall success rate and transfer caesarean section rate between group EA and group CSEA (P>0.05). Group CSEA presented a higher incidence of hypotension than group C (P<0.05). There were no statistical differences in the incidence of fetal heart rate slowing, nausea and vomiting, and placental abruption among the three groups (P>0.05). Conclusions When ECV is performed in women with singleton breech pregnancy, epidural analgesia or combined spinal‑epidural analgesia are more effective in correcting fetal position and reducing the rate of caesarean section. However, the incidence of hypotension is remarkably higher with spinal‑epidural analgesia.