Objective: To examine the relationship between interpregnancy interval (IPI) after previous cesarean section (CS) and perinatal outcomes. Design: Retrospective cohort study. Setting: West China Second University Hospital, Sichuan University, China. Population: A total of 1854 women with a history of CS who delivered from January 2016 to December 2016. Methods: With an IPI of 24-59 months as the reference, the associations between various IPIs (<24, 60-119, and ≥120 months) and perinatal outcomes were examined by multivariate logistic regression analysis with multiple models. Main outcome measures: Adverse maternal and fetal outcomes of different IPIs after CS. Results: IPI <24 months significantly increased the risk of anemia in late pregnancy (aOR 2.09, 95% CI 1.21-2.62, p = 0.008). IPI <24 months was associated with a higher risk for incomplete uterine rupture (OR 1.30, 95% CI 1.05-1.61), IPI ≥60 months was related to a lower risk for incomplete uterine rupture (IPI = 60-119 months: OR 0.77, 95% CI 0.62-0.95; IPI ≥120 months, OR 0.59, 95% CI 0.38-1.08), and women with IPI ≥120 months were more likely to develop gestational hypertension (GHP) (p = 0.036) and gestational diabetes mellitus (GDM) (p = 0.001). These effects became nonsignificant after adjusting possible confounders. Conclusion: IPI <24 months is associated with a higher risk for anemia in late pregnancy. IPI may combine with other factors to affect GHP, GDM, and uterine rupture in the subsequent pregnancy after previous CS. Funding: National Natural Science Foundation of China (No. 81571465). Keywords: Adverse pregnancy outcomes, Birth spacing, Cesarean delivery.