Objective To evaluate the clinical significance of a novel 3D MRI model in determining the precise location of uterine incision and placenta during cesarean section in patients with placenta previa.Methods A prospective study was conducted singleton pregnant women with placenta previa who underwent cesarean delivery were enrolled.All patients underwent routine pelvic MRI examina-tions and were divided into experimental group(40 cases)and control group(31 cases).The MRI data from the experimental group patients were utilized to create 3D models of the uterus and placenta using the open-source software 3D Slicer.General patient infor-mation,surgical records,and Apgar scores of newborns at 1 min and 5 min were collected.Results A total of 71 cases were included.The average surgery time in the experimental group was significantly shorter than that in the control group[(58.6i4.3)min vs(61.4±6.7)min,P=0.036].The experimental group also experienced reduced intraoperative blood loss compared to the control group(median:885.0 mL vs 960.0 mL,P=0.045),as well as shorter hospital stays(median:6.0 d vs 7.0 d,P=0.023).The proportion of newborns with a 1 min Apgar score less than 7 points was significantly lower in the experimental group compared to the control group(12.5％vs 35.5％,P=0.022).However,there was no statistically significant difference in the proportion of new-borns with a 5 min Apgar score less than 7 points between the two groups.Conclusion The utilization of the 3D MRI model in guid-ing cesarean section surgeries can reduce adverse outcomes for pregnant women and improve the 1 min Apgar scores of newborns.