Objective To study the clinical efficacy and safety of external conversion in late preterm breech pregnancy. Methods 166 pregnant women with breech pregnancy admitted to our hospital from May 2021 to May 2023 were selected as the study objects. Pregnant women were divided into control group and study group by random number table method, with 83 cases in each group. The control group was given knee and chest position intervention to correct fetal position; The study group used external conversion to correct fetal position. The results of fetal position correction, pregnancy outcome, neonatal birth and complications of the two groups were analyzed and compared. Results The success rate of fetal position correction was 55.42% in the study group, which was significantly higher than 38.55% in the control group (P < 0.05). The cesarean section rate of the study group was significantly lower than that of the control group, and the vaginal delivery rate was significantly higher than that of the control group (P < 0.05). There was no significant difference in neonatal weight between the two groups (P > 0.05). The amniotic fluid contamination rate of the study group was significantly higher than that of the control group (P < 0.05). NICU occupancy rate in observation group was significantly lower than that in control group (P < 0.05). The rates of premature rupture of membranes and postpartum hemorrhage in the study group were significantly lower than those in the control group (P < 0.05). Conclusion The use of external conversion to correct late pregnancy without full term breech pregnancy can improve the result of fetal position correction and pregnancy outcome, improve newborn birth situation and reduce complications.