Objective To investigate the effects of combined spinal and epidural analgesia on maternal and infant outcomes of trial of labor after cesarean section (TOLAC). Methods A total of 136 pregnant women who underwent TOLAC in Beijing Obstetrics and Gynecology Hospital from June 2011 to October 2018 were enrolled, where 70 women receiving combined spinal and epidural analgesia were set as an observation group and 66 women without analgesia as a control group. Their clinical data were retrospectively analyzed. Both groups were compared for their Bishop scores before analgesia, the first and second stage of labor, the number of device‑assisted delivery, the number of cesarean, the number of uterine rupture cases, adverse reactions and neonatal outcomes. Results Compared with the control group, the observation group presented shortened duration of the first stage of labor ［(455±30) min vs (401±39) min, P<0.05］, langer than nd second stage of labor ［(30±11) min vs (45±16) min, P<0.05］, with a decreased rate of cesarean (18.5% vs 8.6%, P<0.05). There was no statistical difference between the two groups in the Bishop score before analgesia, the use of oxytocin, the number of device‑assisted delivery, uterine rupture and the incidence of postoperative bleeding (P>0.05). Women in the observation group (10.0%) reported an increased rate of itchy skin compared with the control group (0) (P<0.05). There was no statistical difference in the number of hypotension, nausea and vomiting, and respiratory inhibition (P>0.05). There were no statistical difference among newborns in the two groups as to birth weight, 1 min Apgar score, pH value, arterial partial pressure of oxygen (PaO2), arterial partial pressure of carbon dioxide (PaCO2), and residual alkaline (P>0.05). Conclusions Combined spinal and epidural block can significantly relieve labor pain during TOLAC's severe parturition during delivery, reduce cesarean rate, without no adverse effects on neonatal outcomes.